Zeinelabden Khaled Magdy, El-Shazly Mohamed, Alorabi Ammar, Kandeel Hossam, Salman Baher, Aziz Mohammed
Urology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Urology Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt.
World J Urol. 2025 Aug 2;43(1):473. doi: 10.1007/s00345-025-05842-8.
Bladder outlet obstruction mediated underactive bladder represents a challenging condition in which transurethral resection of prostate did not prove to be a sufficient treatment option. Therefore, this study was conducted to evaluate the effects and adverse effects of Pyridostigmine as a treatment for underactive bladder after transurethral resection of prostate.
This prospective, double-blind, randomized controlled study was conducted between May 2024 and November 2024. Sixty-six patients who had benign prostatic hyperplasia with preoperative underactive bladder and eligible for transurethral resection of prostate were randomized into two groups: the Pyridostigmine group, which received Pyridostigmine 120 mg daily for 3 months postoperatively, and the control group, which received placebo postoperatively. Patients were followed-up for 3 months postoperatively to observe symptom changes, urodynamic changes and adverse effects.
Patient who received Pyridostigmine showed significant improvement compared to the control group patients regarding IPSS score (p = 0.001), quality of life (p < 0.001), postvoid residual volume (p = 0.002), maximum flow rate (p < 0.001), contractility index (p = 0.001) and postoperative retention incidence (p = 0.005). Mild adverse effects were reported in 23.5% of patients who received Pyridostigmine with no reported serious adverse effects.
Pyridostigmine after transurethral resection of prostate in patients with underactive bladder with benign prostatic hyperplasia leads to significant improvements in postoperative subjective and objective outcomes with insignificant adverse effects and wide safety profile making Pyridostigmine a therapeutic option for enhancing bladder function recoverability after transurethral resection of prostate.
膀胱出口梗阻介导的膀胱活动低下是一种具有挑战性的病症，经尿道前列腺切除术并非充分的治疗选择。因此，本研究旨在评估吡啶斯的明作为经尿道前列腺切除术后膀胱活动低下治疗方法的疗效及不良反应。
本前瞻性、双盲、随机对照研究于2024年5月至2024年11月进行。66例患有良性前列腺增生且术前膀胱活动低下、适合经尿道前列腺切除术的患者被随机分为两组：吡啶斯的明组，术后3个月每日服用120毫克吡啶斯的明；对照组，术后服用安慰剂。术后对患者进行3个月随访，观察症状变化、尿动力学变化及不良反应。
与对照组患者相比，接受吡啶斯的明治疗的患者在国际前列腺症状评分（p = 0.001）、生活质量（p < 0.001）、排尿后残余尿量（p = 0.002）、最大尿流率（p < 0.001）、收缩力指数（p = 0.001）和术后尿潴留发生率（p = 0.005）方面有显著改善。接受吡啶斯的明治疗的患者中有23.5%报告有轻度不良反应，未报告严重不良反应。
对于患有良性前列腺增生且膀胱活动低下的患者，经尿道前列腺切除术后使用吡啶斯的明可显著改善术后主观和客观结果，不良反应轻微，安全性高，使吡啶斯的明成为增强经尿道前列腺切除术后膀胱功能恢复能力的一种治疗选择。
