aDepartment of Urology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany bDivision of Urology, Federal University of São Paulo (RS), São Paulo, Brazil.
Curr Opin Urol. 2014 Jan;24(1):29-35. doi: 10.1097/MOU.0000000000000003.
Improved understanding of the pathogenesis of lower urinary tract symptoms (LUTS) has led to the development of new drugs to treat male LUTS. The review aims to give an overview to the new drugs and to compounds in the pipeline.
Tadalafil, a phosphodiesterase type 5 inhibitor, is a drug newly approved for the treatment of male LUTS and a true new challenger for the current standard treatment with alpha1 blockers, particularly in men with concomitant erectile dysfunction. Botulinum toxin and mirabegron, a beta3 agonist, might be of value in treating persistent storage LUTS. Intraprostatic injections with botulinum toxin, NX-1207, and PRX302, need further evaluation but might be treatment alternatives in the future. Similarly, vitamin D3 receptor analogues (e.g., elocalcitol), gonadotropin-releasing hormone antagonists (e.g., cetorelix), and modulators of the cannabinoid system (e.g., fatty acid amide hydrolase inhibitors) need further evaluation in clinical studies. Other compounds, such as transient receptor potential vanilloid antagonists, Rho kinase inhibitors, purinergic receptor blockers, and endothelin targeting drugs, are still at experimental stages.
Novel drugs for the treatment of male LUTS have been introduced recently. Clinical practice along with further trials will have to prove their value, along with other compounds that are still in their early phase of development.
对下尿路症状（LUTS）发病机制的深入了解，推动了治疗男性 LUTS 的新药研发。本文旨在概述这些新药和在研药物。
磷酸二酯酶 5 抑制剂他达拉非，是一种新批准用于治疗男性 LUTS 的药物，是目前 α1 受体阻滞剂标准治疗的真正新挑战，尤其是对伴有勃起功能障碍的男性。肉毒毒素和β3 激动剂米拉贝隆可能对治疗持续储尿期 LUTS 有价值。前列腺内注射肉毒毒素、NX-1207 和 PRX302 尚需进一步评估，但可能是未来的治疗选择。同样，维生素 D3 受体类似物（如依洛前列素）、促性腺激素释放激素拮抗剂（如西曲瑞克）和大麻素系统调节剂（如脂肪酸酰胺水解酶抑制剂）需要在临床试验中进一步评估。其他化合物，如瞬时受体电位香草素拮抗剂、Rho 激酶抑制剂、嘌呤能受体阻滞剂和内皮素靶向药物，仍处于实验阶段。
目前已有治疗男性 LUTS 的新药问世。临床实践和进一步的试验将必须证明其价值，以及其他仍处于早期开发阶段的化合物的价值。
