Improvement of Overactive Bladder Symptoms and Bladder Ischemia with Dutasteride in Patients with Benign Prostatic Enlargement

Wada, Naoki; Matsumoto, Seiji; Kita, Masafumi; Hashizume, Kazumi; Κakizaki, Hidehiro

doi:10.1111/luts.12047

Cited by 14 publications

(8 citation statements)

References 18 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Silodosin was also reported to improve bladder flow and voiding frequency in a rat atherosclerosis model (Goi et al 2013). In a series of 30 consecutive men with LUTS and unsatisfied with their symptom improvement during α-blocker treatment, a 24-week add-on treatment with dutasteride reduced prostate size, improved LUTS, and reduced the bladder vascular resistive index (Wada et al 2015). Within this study the 20 men reporting persisting urgency, bladder perfusion was improved to a smaller degree than in the 10 without urgency.…”

Section: Effects Of Therapeutics On Bladder Perfusionmentioning

confidence: 97%

Are blood vessels a target to treat lower urinary tract dysfunction?

Michel

Chess-Williams

Hegde

2015

Naunyn-Schmiedeberg's Arch Pharmacol

View full text Add to dashboard Cite

Bladder dysfunction is common in the general population (Stewart et al. 2010) and even more so among patients seeing a physician for any reason (Goepel et al. 2002). It often manifests as lower urinary tract symptoms (LUTS), a term originally coined to describe voiding and storage symptoms in men with benign prostatic hyperplasia (BPH) but now more universally used to describe any type of voiding and storage symptoms in both sexes. Studies into possible causes of urinary bladder dysfunction have long focused on detrusor smooth muscle cells (Turner and Brading 1999). More recently, it became clear that several other types of cells and organs contribute to regulating detrusor smooth muscle function. These include the urothelium (Andersson and McCloskey 2014; Michel 2015), afferent nerves (Michel and Igawa 2015; Yoshimura et al. 2014b), and the central and autonomic nervous systems (Fowler and Griffiths 2010; Yoshimura et al. 2014a). Alterations in any of these may at least partly be responsible for detrusor dysfunction and, accordingly, be potential targets for the treatment of bladder dysfunction. As highlighted by an article in this issue of Naunyn-Schmiedeberg's Archives of Pharmacology (Bayrak et al. 2015), there is an additional suspect, the bladder vasculature. This article will discuss the currently available experimental and clinical evidence for a role of the vasculature in causing bladder dysfunction, and how existing and emerging treatments may modulate bladder function by acting on blood vessels. Due to a similarity in concept, data on prostate perfusion will also be discussed to some extent.

show abstract

Section: Effects Of Therapeutics On Bladder Perfusionmentioning

confidence: 97%

Are blood vessels a target to treat lower urinary tract dysfunction?

Michel

Chess-Williams

Hegde

2015

Naunyn-Schmiedeberg's Arch Pharmacol

View full text Add to dashboard Cite

show abstract

“…Regulation of tumor necrosis factor‐like ligand 1a (TL1A) and its receptor DR3 by bladder ischemia and potential roles of TL1A and DR3 in bladder inflammation are documented in the elderly patients 20 . Dutasteride (5α‐reductase inhibitor, antiandrogen) is suggested to reduce OAB symptoms by increasing blood flow and improving bladder ischemia 21 …”

Section: Pelvic Ischemiamentioning

confidence: 99%

“…20 Dutasteride (5α-reductase inhibitor, antiandrogen) is suggested to reduce OAB symptoms by increasing blood flow and improving bladder ischemia. 21 Recently, a study of women consisting of 74 OAB patients and 73 controls showed that all atherosclerosis indicators were significantly associated with OAB and that there was a significant relationship between OAB and decreased bladder neck perfusion. It was also found that OAB correlated with severity of systemic atherosclerosis and with impaired vascular perfusion of the bladder.…”

Section: Bladder Ischemia: the Human Datamentioning

confidence: 99%

Are oxidative stress and ischemia significant causes of bladder damage leading to lower urinary tract dysfunction? Report from the ICI‐RS 2019

Speich¹,

Tarcan

Hashitani

et al. 2020

Neurourology and Urodynamics

View full text Add to dashboard Cite

Several studies indicate that pelvic ischemia and oxidative stress may play a significant role in lower urinary tract dysfunction (LUTD), including detrusor overactivity (DO)/overactive bladder (OAB) and detrusor underactivity (DU)/underactive bladder (UAB). The present article addresses proposal 1: “Are oxidative stress and ischemia significant causes of bladder damage leading to LUTD?” from the 2019 International Consultation on Incontinence—Research Society (ICI‐RS) meeting. Bladder ischemia in animals and humans is briefly described, along with the proposed progression from ischemia to LUTD. Bladder ischemia is compared with ischemia of other organs, and the ongoing development of pelvic ischemia animal models is discussed. In addition, the distribution of blood within the bladder during filling and voiding and the challenges of quantification of blood flow in vivo are described. Furthermore, oxidative stress, including potential biomarkers and treatments, and challenges regarding antioxidant therapy for the treatment of LUTD are discussed. Finally, seven critical research questions and proposed studies to answer those questions were identified as priorities that would lead to major advances in the understanding and treatment of lower urinary tract symptoms (LUTS)/LUTD associated with pelvic ischemia and oxidative stress.

show abstract

“…Therefore, if a patient with BPH receives appropriate treatment for BOO, his OAB symptoms are expected to improve. Prior studies reported that medical treatment, such as with an alpha-blocker or 5-alpha-reductase inhibitor, and surgical treatment via transurethral resection of prostate (TURP) both significantly improve voiding symptoms as well as BPH-induced OAB symptoms [567]. …”

Section: Introductionmentioning

confidence: 99%

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

Hur

Kim

et al. 2016

Investig Clin Urol

View full text Add to dashboard Cite

PurposeTo investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH).Materials and MethodsWe retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups.ResultsIn total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement.ConclusionsA preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.

show abstract

Improvement of Overactive Bladder Symptoms and Bladder Ischemia with Dutasteride in Patients with Benign Prostatic Enlargement

Abstract: Reduction of obstruction and improvement of bladder ischemia might play an important role in a beneficial impact of dutasteride on overactive bladder symptoms.

Cited by 14 publications

References 18 publications

Are blood vessels a target to treat lower urinary tract dysfunction?

Are blood vessels a target to treat lower urinary tract dysfunction?

Are oxidative stress and ischemia significant causes of bladder damage leading to lower urinary tract dysfunction? Report from the ICI‐RS 2019

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

Contact Info

Product

Resources

About