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他莫昔芬对尿失禁的影响:病例报告及文献综述。

Effects of tamoxifen on urinary incontinence: Case report and review of literature.

作者信息

Hasanov Elshad, Hasanov Merve, Kuria Issa M, Hasanov Rovshan, Rzazade Reshad, Jonasch Eric, Altundag Kadri

机构信息

Department of Medical Oncology, Hacettepe University Cancer Institute Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey Department of Genitourinary Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Medicine (Baltimore). 2017 Aug;96(34):e6785. doi: 10.1097/MD.0000000000006785.

Abstract

RATIONALE

Tamoxifen has been used in women with hormone receptor-positive breast cancer and has been shown to successfully reduce both recurrence and mortality. On the contrary, long-term use of tamoxifen has hormone-related urogenital side effects which decrease the quality of life of the patients.

PATIENT CONCERNS

In this case report, we present a breast cancer patient receiving tamoxifen who developed urinary incontinence; we discuss the effects of tamoxifen on urinary incontinence, which decreases quality of life of the patients who were evaluated in our clinic.

DIAGNOSES

Breast cancer, urinary incontinence.

INTERVENTIONS

Temporarily discontinuing tamoxifen.

OUTCOMES

Urinary incontinence resolved.

LESSONS

Based on the case we reported and literature, estrogen can cause a dose-dependent increase in incontinence, but more preclinical and clinical studies of both estrogen and SERMs are needed to support this notion; given the fact that some small-scale clinical studies have not proven a direct relationship between tamoxifen and urinary incontinence. We suggest that clinicians faced with the issue should temporarily stop usage of the drug once the complaint of urinary incontinence arises.

摘要

理论依据

他莫昔芬已用于激素受体阳性乳腺癌女性患者,且已证实能成功降低复发率和死亡率。相反,长期使用他莫昔芬会产生与激素相关的泌尿生殖系统副作用,降低患者生活质量。

患者情况

在本病例报告中,我们介绍了一名接受他莫昔芬治疗的乳腺癌患者出现了尿失禁;我们讨论了他莫昔芬对尿失禁的影响,尿失禁降低了在我们诊所接受评估的患者的生活质量。

诊断

乳腺癌、尿失禁。

干预措施

暂时停用他莫昔芬。

结果

尿失禁症状消失。

经验教训

根据我们报告的病例及文献,雌激素可导致尿失禁呈剂量依赖性增加,但需要更多关于雌激素和选择性雌激素受体调节剂的临床前和临床研究来支持这一观点;鉴于一些小规模临床研究尚未证实他莫昔芬与尿失禁之间存在直接关系。我们建议,临床医生遇到该问题时,一旦患者出现尿失禁主诉,应暂时停用该药物。

相似文献

10
Controversies regarding tamoxifen and uterine carcinoma.
Curr Opin Obstet Gynecol. 1998 Feb;10(1):9-14. doi: 10.1097/00001703-199802000-00003.

本文引用的文献

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Local oestrogen for vaginal atrophy in postmenopausal women.局部雌激素用于绝经后女性的阴道萎缩
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Rho kinase: a target for treating urinary bladder dysfunction?Rho激酶:治疗膀胱功能障碍的一个靶点?
Trends Pharmacol Sci. 2006 Sep;27(9):492-7. doi: 10.1016/j.tips.2006.07.002. Epub 2006 Jul 25.

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