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绝经后膀胱过度活动症

Postmenopausal overactive bladder.

作者信息

Tomaszewski Jacek

机构信息

2 Department of Gynecology, Medical University of Lublin, Poland.

出版信息

Prz Menopauzalny. 2014 Dec;13(6):313-29. doi: 10.5114/pm.2014.47984. Epub 2014 Dec 30.

Abstract

Bladder storage symptoms have a severe impact on many areas as regards the quality of life including health-related, social, psychological and working functions. Pharmacotherapy of lower urinary tract stores (LUTS) has been developed to optimize neural control of the lower urinary tract in pathologic states. The bladder can be overactive or underactive. Overactive bladder (OAB) is highly prevalent and is associated with considerable morbidity, especially in aging population. Therefore, an effective treatment of OAB must result in a meaningful reduction in urinary symptoms. Pharmacotherapy for the OAB must be individualized based on the degree of bother, medication side-effect profile, concomitant comorbidities and current medication regimen. Antimuscarinic agents will continue to represent the current gold standard for the first-line pharmacological management of OAB. Alternatively to antimuscarinic therapy, β3-adrenergic receptor agonists, due to their efficacy and favorable adverse event profile, are a novel and attractive option of pharmacological treatment of overactive bladder symptoms. A combination of selective antimuscarinic and β3-adrenergic receptor agonists, agents with the different mechanism of action, gives a new treatment option for the patient with OAB according to its harms profile. A number of putative novel therapeutic agents is under clinical evaluations that may ultimately provide alternative or combination treatment options for OAB in the nearest future.

摘要

膀胱储尿症状在生活质量的许多方面都有严重影响,包括与健康相关的、社会的、心理的和工作功能。下尿路储尿期症状(LUTS)的药物治疗已得到发展,以优化病理状态下下尿路的神经控制。膀胱可能过度活跃或活动不足。膀胱过度活动症(OAB)非常普遍,且与相当高的发病率相关,尤其是在老年人群中。因此,有效的OAB治疗必须能显著减轻尿路症状。OAB的药物治疗必须根据困扰程度、药物副作用情况、合并症以及当前用药方案进行个体化。抗胆碱能药物将继续作为OAB一线药物治疗的当前金标准。作为抗胆碱能治疗的替代方法,β3肾上腺素能受体激动剂因其疗效和良好的不良事件谱,是治疗膀胱过度活动症症状的一种新颖且有吸引力的药物治疗选择。选择性抗胆碱能药物和β3肾上腺素能受体激动剂这两种作用机制不同的药物联合使用,根据其危害情况,为OAB患者提供了一种新的治疗选择。一些假定的新型治疗药物正在进行临床评估,可能最终在不久的将来为OAB提供替代或联合治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a686/4352916/f8760aac1add/MR-13-24254-g001.jpg

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