University of Patras, Medical School, Department of Urology, Patras, Greece.
Curr Opin Urol. 2013 Nov;23(6):515-9. doi: 10.1097/MOU.0b013e328363fbf1.
To summarize data concerning the medical treatment of men with overactive bladder symptoms published in peer-reviewed journals between January 2012 and March 2013.
Results of large, randomized trials of solifenacin in combination with tamsulosin in men with lower urinary tract symptoms, including voiding and storage ones, have dominated the medical literature on the subject for the past 12-16 months. Solifenacin in upfront combination with alpha-blockers or as add-on therapy in men with residual storage symptoms despite alpha-blockade offers additional benefits in symptom control. In accordance with data from previous studies on other antimuscarinics, improvements are significant only for some of the efficacy outcomes. Solifenacin in combination with alpha-blockers is associated with an increase in postvoid residual urine volume but not a significantly increased risk of retention. Recent data also indicate that the combination of antimuscarinics with alpha-blockers is cost-effective with long-term efficacy and safety.
Recent evidence further supports the efficacy and safety of antimuscarinics in combination with alpha-blockers in treating storage symptoms in men with lower urinary tract symptoms. More studies are needed to evaluate criteria for selecting men likely to benefit more from antimuscarinics and investigate other overactive bladder treatments in male populations.
总结 2012 年 1 月至 2013 年 3 月期间同行评议期刊中关于男性膀胱过度活动症的医学治疗数据。
过去 12-16 个月，索利那新联合坦索罗辛治疗下尿路症状（包括排尿和储尿症状）的大型随机试验结果主导了该主题的医学文献。对于尽管接受了α受体阻滞剂治疗仍有残余储尿症状的男性，索利那新联合α受体阻滞剂或作为附加治疗可提供额外的症状控制益处。与先前关于其他抗毒蕈碱药物的研究数据一致，仅对某些疗效结果有显著改善。索利那新联合α受体阻滞剂与增加残余尿量相关，但与留置风险增加无关。最近的数据还表明，抗毒蕈碱药物与α受体阻滞剂联合使用具有长期疗效和安全性，具有成本效益。
最近的证据进一步支持了抗毒蕈碱药物联合α受体阻滞剂治疗男性下尿路症状中储尿症状的疗效和安全性。需要更多的研究来评估选择可能从抗毒蕈碱药物中获益更多的男性的标准，并研究男性人群中的其他膀胱过度活动症治疗方法。
