Urodynamic Effects of Dutasteride Add-On Therapy to Alpha-Adrenergic Antagonist for Patients With Benign Prostatic Enlargement: Prospective Pressure-Flow Study
Urodynamic Effects of Dutasteride Add-On Therapy to Alpha-Adrenergic Antagonist for Patients With Benign Prostatic Enlargement: Prospective Pressure-Flow Study
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DOI：
10.1002/nau.22349
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发表时间：
2013-11-01
影响因子：
2
通讯作者：
Kakizaki, Hidehiro
中科院分区：
文献类型：
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作者：
Wada, Naoki;Kita, Masafumi;Kakizaki, Hidehiro
目的前瞻性研究度他雄胺对良性前列腺增生症(BPE)患者临床和尿动力学参数的影响。材料与方法对52例对α-肾上腺素能拮抗剂单一治疗不满意的BPE患者进行前瞻性研究。纳入标准为前列腺体积(PV)30ml，国际前列腺症状评分(IPSS)8分或生活质量指数3。治疗前和治疗24周后，分别进行IPSS、尿流率(UFM)、充盈膀胱测压(PFS)和压力-流率研究(PFS)。结果杜他司特治疗后IPSS评分从18.47.5增加到13.8+/-7.3，最大尿流率从11.4+/-5.6增加到13.0+/-6.8ml/s。添加度他雄胺的充盈膀胱测压的最大容量没有显著变化(添加度他雄胺前后分别为221+/-97和240+/-104ml)。加用度他雄胺治疗前有逼尿肌过度活动(DO)的41例患者，加用度他雄胺治疗后，逼尿肌不自主收缩幅度均明显降低，其中7例DO消失。度他雄胺显著降低PV，从66.4+/-31.9降至47.6+/-26.1毫升。在PFS中，加用度他雄胺后，最大尿流率时的逼尿肌压从71.5+/-30.1降至59.1+/-24.9cmH(2)O。膀胱出口梗阻指数(BOOI)由55.2+/-31.9降至42.3+/-27.9，Schafer诺模图评估的梗阻程度明显改善。结论度他雄胺可改善下尿路症状，改善膀胱功能，解除梗阻。诺鲁罗。乌罗代南。2013年，32：1123-1127。(C)2013年威利期刊公司。
AimsWe prospectively investigated the effect of dutasteride on clinical and urodynamic parameters in patients with benign prostatic enlargement (BPE).Materials and MethodsA prospective study was conducted in consecutive 52 patients with BPE who had not been satisfied with alpha-adrenergic antagonist monotherapy. Inclusion criteria were prostate volume (PV) 30ml and the International Prostate Symptom Score (IPSS) 8 or QOL index 3 under administration of an alpha-adrenergic antagonist without anticholinergic agent. Before and 24 weeks after dutasteride (0.5mg daily) add-on treatment with preceding alpha-adrenergic antagonist, we assessed IPSS, uroflowmetry (UFM), filling cystometry, and pressure-flow study (PFS).ResultsDutasteride add-on treatment significantly improved IPSS (from 18.47.5 to 13.8 +/- 7.3) and maximum flow rate (from 11.4 +/- 5.6 to 13.0 +/- 6.8ml/sec). Maximum cystometric capacity on filling cystometry did not change significantly by dutasteride add-on treatment (221 +/- 97 and 240 +/- 104ml before and after dutasteride add-on, respectively). All of the 41 patients with detrusor overactivity (DO) before dutasteride add-on treatment showed apparent reduction in the amplitude of involuntary detrusor contraction after dutasteride add-on treatment, including seven in whom DO disappeared. Dutasteride significantly reduced PV from 66.4 +/- 31.9 to 47.6 +/- 26.1ml. In PFS, detrusor pressure at maximum flow rate (PdetQmax) significantly decreased from 71.5 +/- 30.1 to 59.1 +/- 24.9cmH(2)O after dutasteride add-on treatment. Bladder outlet obstruction index (BOOI) also decreased significantly from 55.2 +/- 31.9 to 42.3 +/- 27.9, and obstruction grade assessed by the Schafer nomogram significantly improved.ConclusionsDutasteride can improve lower urinary tract symptoms by improving storage bladder function and relieving obstruction. Neurourol. Urodynam. 32:1123-1127, 2013. (c) 2013 Wiley Periodicals, Inc.