Kuzmenko A V, Kuzmenko V V, Gyaurgiev T A
Department of Urology of the FGBOU VO Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia.
Urologiia. 2023 Dec(6):14-21.
Benign prostatic hyperplasia (BPH) can lead to the detrusor hypertrophy and deterioration of the bladder function with a decrease in its contractile activity. A number of publications are presented in the literature, the results of which indicate the possibility of reducing bladder hypertrophy with alpha-blockers.
To carry out the retrospective analysis to study the effect of Alfuprost MR on urodynamic parameters, as well as the influence of the therapy on detrusor thickness and bladder mass in patients with detrusor hypertrophy and bladder outlet obstruction caused by BPH.
Outpatient records of 30 patients with lower urinary tract symptoms (LUTS) caused by BPH who received Alfuprost MR as monotherapy for 24 weeks were reviewed. Based on the diaries, the following parameters were assessed: total IPSS score, IPSS voiding (questions No. 1, 3, 5 and 6) and storage subscale scores (questions No. 2, 4 and 7), maximum flow rate (Qmax) according to uroflowmetry, the volume of the prostate and the postvoid residual (assessed by ultrasound), satisfaction with treatment on the quality-of-life score (QoL), as well as the changes in detrusor thickness and bladder mass index.
An improvement in LUTS severity, starting from the 4th week of treatment, followed by a positive trend that persists until the 24th week of therapy with Alfuprost MR, was found. The overall average IPSS score improved by 39.0% by the 24th week of therapy. At the same time, voiding symptoms improved by 46.8%, and storage symptoms improved by 30.9% by 24 weeks of therapy. The average Qmax increased significantly (p<0.05) by 22.1% after 24 weeks of therapy. The average detrusor thickness decreased by 40,2%. Bladder mass index decreased significantly by an average of 34,3% (p<0.05). QoL score improved significantly (p<0.05) by 2.2 points after 24 weeks of therapy.
During the 24-week treatment of patients with BPH, Alfuprost MR demonstrated clinical efficacy not only in reducing voiding symptoms and in improving the QoL, but also a positive effect on detrusor hypertrophy, as evidenced by changes in detrusor thickness and bladder mass index. The absence of any adverse events, including decrease in blood pressure and heart rate, allows us to recommend Alfuprost MR as an effective treatment for LUTS associated with BPH, which reduces detrusor hypertrophy and has a high safety profile and minimal vasodilating effects.
良性前列腺增生(BPH)可导致膀胱逼尿肌肥大及膀胱功能恶化,其收缩活动降低。文献中有多篇报道,结果表明α受体阻滞剂有可能减轻膀胱肥大。
进行回顾性分析,以研究阿尔夫前列素MR对尿动力学参数的影响,以及该疗法对BPH所致逼尿肌肥大和膀胱出口梗阻患者逼尿肌厚度和膀胱质量的影响。
回顾了30例因BPH引起下尿路症状(LUTS)并接受阿尔夫前列素MR单药治疗24周的门诊患者记录。根据日记,评估以下参数:国际前列腺症状评分(IPSS)总分、IPSS排尿(第1、3、5和6题)及储尿亚评分(第2、4和7题)、尿流率测定的最大尿流率(Qmax)、前列腺体积和残余尿量(通过超声评估)、生活质量评分(QoL)对治疗的满意度,以及逼尿肌厚度和膀胱质量指数的变化。
发现从治疗第4周开始,LUTS严重程度有所改善,随后呈积极趋势,直至阿尔夫前列素MR治疗第24周。到治疗第24周时,IPSS总分总体平均改善了39.0%。同时,排尿症状改善了46.8%,储尿症状在治疗24周时改善了30.9%。治疗24周后,平均Qmax显著增加(p<0.05),增幅为22.1%。平均逼尿肌厚度下降了40.2%。膀胱质量指数平均显著下降34.3%(p<0.05)。治疗24周后,QoL评分显著改善(p<0.05),提高了2.2分。
在对BPH患者进行24周治疗期间,阿尔夫前列素MR不仅在减轻排尿症状和改善QoL方面显示出临床疗效,而且对逼尿肌肥大也有积极作用,逼尿肌厚度和膀胱质量指数的变化证明了这一点。未出现任何不良事件,包括血压和心率下降,这使我们能够推荐阿尔夫前列素MR作为治疗与BPH相关的LUTS的有效药物,它可减轻逼尿肌肥大,具有高安全性和最小的血管舒张作用。