Matsuo Tomohiro, Miyata Yasuyoshi, Araki Kyohei, Mukae Yuta, Otsubo Asato, Ohba Kojiro, Sakai Hideki
Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Low Urin Tract Symptoms. 2020 Jan;12(1):47-53. doi: 10.1111/luts.12283. Epub 2019 Aug 13.
To evaluate the effects of tadalafil monotherapy on lower urinary tract symptoms, urodynamic parameters, and oxidative stress levels in male patients.
This prospective study included 53 male patients with urinary symptoms, who met the criteria for overactive bladder (OAB) (≥ 2 points for Q3 [urgency] in the OAB symptom score [OABSS] assessment and ≥ 3 points for the total score). The patients received 5 mg tadalafil orally once daily, and their symptoms were assessed before and after the 12-week treatment. The OABSS and international prostate symptom score (IPSS) were used to evaluate the subjective symptoms. The objective findings were assessed using uroflowmetry. Oxidative stress was assessed by determining urinary levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels with an adjustment for urinary creatinine (CR) concentration.
After tadalafil administration, total and individual indices of the OABSS assessment showed significant improvement. In addition, total storage and voiding symptoms that contributed to the IPSS were also significantly improved. The voided volume was increased, and the maximum flow rate was improved after tadalafil treatment (P = .002 and < 0.001, respectively). Urinary 8-OHdG/CR decreased from 12.4 ± 9.7 ng/mg CR to 7.6 ± 11.6 ng/mg CR (P < .001). In patients who showed OAB improvement and did not meet the criteria for OAB after the treatment (44 patients, 83.0%), the urinary 8-OHdG/CR level was significantly decreased from 11.6 ± 8.4 ng/mg CR to 6.4 ± 10.3 ng/mg CR (P < .001).
Tadalafil treatment improves OAB symptoms and urodynamic parameters by decreasing oxidative stress level.
评估他达拉非单药治疗对男性患者下尿路症状、尿动力学参数及氧化应激水平的影响。
这项前瞻性研究纳入了53例有排尿症状的男性患者，这些患者符合膀胱过度活动症（OAB）标准（OAB症状评分[OABSS]评估中尿急症状[Q3]≥2分且总分≥3分）。患者每天口服5毫克他达拉非一次，在12周治疗前后评估其症状。使用OABSS和国际前列腺症状评分（IPSS）评估主观症状。通过尿流率测定评估客观结果。通过测定尿中8-羟基-2'-脱氧鸟苷（8-OHdG）水平并校正尿肌酐（CR）浓度来评估氧化应激。
服用他达拉非后，OABSS评估的总分及各项指标均有显著改善。此外，对IPSS有影响的总储尿和排尿症状也有显著改善。他达拉非治疗后，排尿量增加，最大尿流率提高（P分别为0.002和<0.001）。尿8-OHdG/CR从12.4±9.7 ng/mg CR降至7.6±11.6 ng/mg CR（P<0.001）。在治疗后显示OAB改善且不符合OAB标准的患者（44例，83.0%）中，尿8-OHdG/CR水平从11.6±8.4 ng/mg CR显著降至6.4±10.3 ng/mg CR（P<0.001）。
他达拉非治疗通过降低氧化应激水平改善OAB症状和尿动力学参数。
