膀胱内前列腺突出的超声图像特征表明,非那雄胺和多沙唑嗪药物治疗对良性前列腺增生(LUTS/BPH)患者无效。

Ultrasound image features of intravesical prostatic protrusion indicated failure of medication therapy of finasteride and doxazosin in patients with benign prostatic hyperplasia (LUTS/BPH).

作者信息

Liu Qiang, Zhu Yunkai, Liu Jianping, Qi Jun, Kang Jian

机构信息

Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China.

Department of Ultrasonography, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China.

出版信息

Int Urol Nephrol. 2017 Mar;49(3):399-404. doi: 10.1007/s11255-016-1478-6. Epub 2016 Dec 16.

Abstract

BACKGROUND

Intravesical prostatic protrusion (IPP) is a type of benign prostatic hyperplasia (BPH) adenoma, and it plays a critical role in the pathogenesis of bladder outlet obstruction in patients with lower urinary tract syndromes (LUTS/BPH).

AIMS

The goal of this study was to investigate the effect of a combination therapy with finasteride and doxazosin on IPP in BPU/LUTS patients.

METHODS

A total of 322 BPH patients with enlarged prostatic volume as well as moderate to severe symptom scores were enrolled and divided into four groups according to the degree of IPP (IPP > 10 mm, 5-10 mm, <5 mm and no IPP) in this study. Aggravated International Prostatic Symptom Score (IPSS), acute urinary retention or relevant urinary complications were considered as failure of the therapy. The degrees of IPP were recorded before and after 6 months of treatment. Student's t test and χ were performed between the baseline and endpoint of the therapy.

RESULTS

The results showed that the total prostate volume (TPV) and transition zone volume (TZV) of the prostate decreased significantly after 6-month combination therapy (P < 0.05), while no significant changes in IPP were observed at that point (P > 0.05). Failure rates of the medication differed significantly among the four groups.

CONCLUSIONS

The study indicated that the combination therapy using finasteride and doxazosin could not reduce the degree of IPP. LUTS/BPH patients with IPP which contributes to the failure of medication tend to have a higher risk of progression.

摘要

背景

膀胱内前列腺突出(IPP)是良性前列腺增生(BPH)腺瘤的一种类型,在伴有下尿路症状(LUTS/BPH)患者的膀胱出口梗阻发病机制中起关键作用。

目的

本研究的目的是探讨非那雄胺和多沙唑嗪联合治疗对BPU/LUTS患者IPP的影响。

方法

本研究共纳入322例前列腺体积增大且症状评分为中度至重度的BPH患者,根据IPP程度(IPP>10mm、5-10mm、<5mm和无IPP)分为四组。国际前列腺症状评分(IPSS)加重、急性尿潴留或相关泌尿系统并发症被视为治疗失败。在治疗6个月前后记录IPP程度。在治疗的基线和终点之间进行t检验和χ检验。

结果

结果显示,联合治疗6个月后前列腺总体积(TPV)和前列腺移行区体积(TZV)显著减小(P<0.05),但此时IPP无显著变化(P>0.05)。四组药物治疗失败率差异显著。

结论

该研究表明,非那雄胺和多沙唑嗪联合治疗不能降低IPP程度。伴有导致药物治疗失败的IPP的LUTS/BPH患者往往有更高的疾病进展风险。

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