Comparison of 7 alpha(1)-adrenoceptor antagonists in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia:a short-term crossover study.
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A crossover study was conducted to identify the best alpha1-adrenoceptor (alpha1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). One hundred thirteen patients (mean age 70.8 years) were enrolled. All patients met BPH clinical study guidelines. Seven agents were utilized:tamsulosin 0.2mg, silodosin 8mg, urapidil 60mg, naftopidil 50mg, prazosin 1mg, terazosin 2mg, and doxazosin 1mg. Patients were initially prescribed tamsulosin or silodosin for a week and then urapidil for a week. Two weeks later, they were prescribed the better of the 2 agents for a week and a new agent for the next week. This cycle was repeated until all 7 agents were tested. Efficacy was evaluated with the International Prostate Symptom Score. The agent rankings were doxazosin (25 [22%]), silodosin (22 [19%]), urapidil (19 [17%]), naftopidil (17 [15%]), terazosin (12 [11%]), tamsulosin (11 [10%]), prazosin (7 [6%]). Only 12 patients (11%) changed agents after the crossover study was completed. The major reason was adverse events (83%). We found that each of the 7 alpha1AR antagonists has its own supporters. Further, the one-week crossover study was useful in identifying the best agent for the treatment of each individual with LUTS. (+info)
The effects of age, metabolic syndrome, nocturnal polyuria and sleep disorders on nocturia.
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BACKGROUND: Nocturia, which is especially frequent among older men, adversely affects the individual's quality of life. It is regarded as one of the most bothersome lower urinary tract symptoms (LUTS). OBJECTIVES: The aim of the study was to investigate factors contributing to the frequency of nocturia. MATERIAL AND METHODS: Men >/= 40 years with LUTS were enrolled in this study. After medical histories were taken and physical examinations conducted, biochemical tests and measures for LUTS were carried out. Anthropometric measurements were performed and Epworth scores (ES) were examined. Patients were divided into two groups with respect to nocturia: the first group having no nocturia or one incident of nocturia per night, and the second group with two or more nightly incidents of nocturia. The data were analyzed statistically; p < 0.05 was considered significant. RESULTS: A total of 118 consecutive patients (56 +/- 10 years) were enrolled in the study. The first group consisted of 31 participants, while the second group contained 87 patients. The groups differed significantly with respect to age, body height, body weight, waist circumference and body mass index (BMI). ES, prostatic volumes, maximum flow rates (Qmax) and international prostate symptom scores (IPSS) were significantly different. Fasting blood glucose levels were similar for both groups. Homeostasis model assessment (HOMA) scores showed borderline significance. Insulin levels were different, while insulin resistance (IR) was similar between the groups. Nocturnal polyuria was associated with nocturia, systolic blood pressure and IPSS. CONCLUSIONS: Age, nocturnal polyuria, metabolic syndrome and sleep disturbances have been shown to be contributing factors in the frequency of nocturia and LUTS. Therefore, steps taken to alleviate factors that can be altered - such as hypertension, weight gain, sleep disturbances and IPSS - may improve the individual's quality of life. (+info)
OBJECTIVE: To investigated the effect and mechanism of Fangjihuangqi Tang (FHT) on lower urinary tract dysfunction induced by benign prostatic hyperplasia (BPH) in rats. METHODS: Male rats were randomly divided into seven groups: normal, model, finasteride (0.5 mg/ kg), terazosin (0.5 mg/kg), and FHT (10, 5, 2.5 g/kg). Rats were administered testosterone (0.5 mg sc) for 6 weeks after orchiectomy, excluding the normal group. All rats were intragastrically administered assigned drugs for 4 weeks from the third week. Urodynamics were assessed in rats under anesthesia. Serum dihydrotestosterone (DHT) and prostatic acid phosphatase (PAP) were measured. The prostate index (PI), bladder index (BI), and pathological detection were evaluated. RESULTS: In the model group, the PI, BI, serum DHT, serum PAP, threshold pressure (TP), micturition pressure (MP), and residual urine volume (RV) were significantly higher. Moreover, inter-micturition duration (IMD) was significantly lower and the prostatic and bladder showed obvious pathological changes. The IMD was significantly higher, while BI, TP, MP, and RV were significantly lower and bladder pathological changes were alleviated in the FHT (10, 5 g/kg), finasteride, and terazosin groups. The PI, DHT, and PAP were significantly lower in the finasteride group, but they did not change significantly in the FHT (10, 5, 2.5 g/kg) and terazosin groups. CONCLUSION: FHT could relieve symptoms of lower urinary tract dysfunction in BPH rats but with no apparent effect on reducing the volume of the enlarged prostate itself. (+info)
Treatment of anterior vaginal wall prolapse with and without polypropylene mesh: a prospective, randomized and controlled trial - Part I.
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