El-Tatawy Hassan, Gameel Tarek, El-enen Mohammed Abo, Hagras Ayman, Mousa Ayman, El-Bahnasy Abdel Hamid, Raheem Ali Abdel, Abu-dewan Khaled
Urology Department, Tanta University Hospital.
Arch Ital Urol Androl. 2015 Sep 30;87(3):238-42. doi: 10.4081/aiua.2015.3.238.
To evaluate the impact of the prostatic-urethral angulation (PUA) on the treatment efficacy of selective alpha-1A receptor blocker in male patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH).
A total of 80 patients with LUTS/BPH and with mean age 53.3 ± 6.3 (range 47-70) were included in our prospective comparative study. The patients were classified into 2 groups as a consecutive cases 40 in each one depending on the PUA either ≤ 35° (group A) or > 35° (group B). PUA and different prostatic parameters were measured using transrectal ultrasound. Prostate-specific antigen (PSA), the International Prostate Symptom Score and quality of life score (IPSS/QoL score), maximum flow rate (Qmax), and postvoid residual (PVR) volume were compared between the groups. The clinical significance of PUA was evaluated after 8 weeks of medical treatment with tamsulosin hydrochloride 0.4 mg daily.
Baseline evaluation (pre-treatment) for both groups were comparable to each other with no clinically significant difference regarding age, PSA, IPSS/QoL score, Q(max) and PVR volume (P-value > 0.05). Comparison of parameters after 8 weeks showed that tamsulosin hydrochloride improved the total IPSS and all subscores (P < 0.001), QoL (P = 0.001), Q(max) (P = 0.002), and PVR (P = 0.04) in group A (Table 1).
Tamsulosin hydrochloride appears to be less effective in improving IPSS/Qol score, Qmax and PVR in patients with lager PUA. The PUA might be a predictor for the treatment efficacy of α-blockers and more studies are warranted in the future before the final conclusion.
评估前列腺尿道角（PUA）对良性前列腺增生继发下尿路症状（LUTS/BPH）男性患者选择性α-1A受体阻滞剂治疗效果的影响。
我们的前瞻性对照研究纳入了80例LUTS/BPH患者，平均年龄53.3±6.3岁（范围47 - 70岁）。根据PUA将患者连续分为两组，每组40例，PUA≤35°为A组，PUA>35°为B组。使用经直肠超声测量PUA和不同的前列腺参数。比较两组之间的前列腺特异性抗原（PSA）、国际前列腺症状评分和生活质量评分（IPSS/QoL评分）、最大尿流率（Qmax）和残余尿量（PVR）。在每天服用0.4mg盐酸坦索罗辛药物治疗8周后，评估PUA的临床意义。
两组的基线评估（治疗前）彼此相当，在年龄、PSA、IPSS/QoL评分、Q（max）和PVR体积方面无临床显著差异（P值>0.05）。8周后参数比较显示，盐酸坦索罗辛改善了A组的总IPSS及其所有子评分（P<0.001）、QoL（P = 0.001）、Qmax（P = 0.002）和PVR（P = 0.04）（表1）。
盐酸坦索罗辛在改善PUA较大患者的IPSS/Qol评分、Qmax和PVR方面似乎效果较差。PUA可能是α受体阻滞剂治疗效果的一个预测指标，未来在得出最终结论之前还需要更多研究。
