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伴发膀胱过度活动症和良性前列腺增生的治疗

Treatment of Concomitant OAB and BPH.

作者信息

Moss Matthew C, Rezan Tameem, Karaman Umar R, Gomelsky Alex

机构信息

Department of Urology, Louisiana State University Health - Shreveport, 1501 Kings Highway, Shreveport, LA, 71130, USA.

出版信息

Curr Urol Rep. 2017 Jan;18(1):1. doi: 10.1007/s11934-017-0649-z.

Abstract

The etiology of men's lower urinary tract storage and voiding symptoms involves a contribution from both detrusor and outlet. As such, treatment of benign prostatic enlargement (BPE) ± benign prostatic obstruction (BPO) with standard alpha-adrenergic blockade and 5-alpha reductase inhibitor therapy may leave a population of men with persistent and bothersome urinary storage symptoms. An abundance of adequately powered, randomized, placebo-controlled trials indicate that the use of antimuscarinics and beta-3 adrenergic agonists, either alone or in combination with standard BPE/BPO therapy, leads to improvement in storage symptoms. At the same time, metrics associated with urinary emptying, such as maximum flow rate, post-void residual urinary volume, and incidence of treatment-associated urinary retention, appear to be stable and not significantly impacted by the addition of antimuscarinics.

摘要

男性下尿路储尿和排尿症状的病因涉及逼尿肌和尿道外括约肌两方面。因此,采用标准的α-肾上腺素能阻滞剂和5-α还原酶抑制剂疗法治疗良性前列腺增生(BPE)±良性前列腺梗阻(BPO),可能会使一部分男性仍存在持续且困扰的储尿症状。大量有充分统计学效力的随机安慰剂对照试验表明,单独使用抗毒蕈碱药物和β-3肾上腺素能激动剂,或与标准的BPE/BPO疗法联合使用,均可改善储尿症状。同时,与尿排空相关的指标,如最大尿流率、排尿后残余尿量以及治疗相关尿潴留的发生率,似乎保持稳定,且不会因加用抗毒蕈碱药物而受到显著影响。

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