Lower urinary tract symptoms in men

Hollingsworth, John M.; Wilt, Timothy J

doi:10.1136/bmj.g4474

Cited by 51 publications

(44 citation statements)

References 116 publications

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“…About half the number of men with BPH develop an enlarged prostate gland, called benign prostatic enlargement (BPE), and among these, about half develop bladder outlet obstruction (BOO) [1]. BOO and/or changes in smooth muscle tone and resistance that can accompany BPH often result in lower urinary tract symptoms (LUTS) [2].…”

Section: Introductionmentioning

confidence: 99%

Transitional Zone Index as a Predictor of the Efficacy of α-Blocker and 5α-Reductase Inhibitor Combination Therapy in Korean Patients with Benign Prostatic Hyperplasia

Choi

Kim²,

Ahn³

2016

Urol Int

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Introduction: We investigated the value of the transitional zone index (TZI) for predicting treatment response to combination therapy involving α-blockers and 5α-reductase inhibitors for benign prostatic hyperplasia (BPH). Materials and Methods: Symptomatic BPH patients (n = 118) were randomized to receive 0.2 mg tamsulosin alone or with 0.5 mg dutasteride daily for 12 months. The TZI, International Prostate Symptom Scores, maximum urinary flow rates (Q_max), postvoid residual urine volumes, and prostate-specific antigen (PSA) were evaluated at baseline and after 12 months. The groups were subdivided according to a cut-off TZI value of 0.5 to compare treatment-related changes. Results: After 12 months, the combination therapy group had significantly greater decreases in prostate volume (p < 0.001), TZ volume (p < 0.001) and PSA (p < 0.001) than the monotherapy group, regardless of TZI. However, combination therapy resulted in significantly greater Qmax increases (p < 0.001) only in patients with a TZI ≥0.5. Multivariate analysis determined that TZI was the strongest independent predictor of the Qmax increase at 12 months in the combination therapy group (β = 13.7, p < 0.001). Conclusions: Greater Qmax improvement is expected with combination therapy comprising α-blockers and 5α-reductase inhibitors for patients with a TZI ≥0.5. The TZI may be useful for predicting the Qmax response to combination treatment for BPH.

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Section: Introductionmentioning

confidence: 99%

Transitional Zone Index as a Predictor of the Efficacy of α-Blocker and 5α-Reductase Inhibitor Combination Therapy in Korean Patients with Benign Prostatic Hyperplasia

Choi

Kim²,

Ahn³

2016

Urol Int

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“…However, adverse events related to alpha-1a interactions, such as floppy iris syndrome, are matters of concern (36). Therefore, non-selective alpha-1 antagonists remain a good alternative for the treatment of LUTS (37).…”

Section: Discussionmentioning

confidence: 99%

ALPHA ANTIADRENERGIC EFFECT OF Achyrocline bogotensis EXTRACT (“Vira Vira”) IN ISOLATED RAT AORTIC RING

Lara

Rincón

Guerrero

2017

Vitae

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Background: The treatment of symptoms of prostatic hyperplasia is among the traditional uses of Achyrocline bogotensis (Kunth) [N.V. "Vira Vira", Compositae] in Colombia. Pharmacological therapy for this disorder depends mainly on alpha-1 antiadrenergic agents, and the mechanism has not been studied previously using A. bogotensis. Objectives: To assess the alpha-1 antiadrenergic effect of the extract obtained from the aerial parts of A. bogotensis in isolated aortic rings from Wistar rats. Methods: The study compared the effects of the ethanol extract of A. bogotensis, prazosin (reference) and DMSO (control) in rings stimulated with phenylephrine (PE) or KCl. The capacity to reduce the PE pressor effect by the ethanol extract (pD 2 ' value) was determined. To quantify the A. bogotensis relaxant potency, increasing concentrations of the ethanol extract (0.1 µg/mL-0.1 mg/mL), were added cumulatively to isolated aortic rings pre-contracted with PE (0.1 µM) or KCl (80 mM). To explore the possible participation of nitric oxide (NO), L-NAME (100 µM) was administered to aortic rings exposed to cumulatively increasing concentrations of PE in isolated aortic rings in the presence of the extract (10 µg/mL). Aqueous, butanol and dichloromethane fractions (10 µg/mL) obtained from the ethanol extract were assayed. Phytochemical screening was also performed. Results: Prazosin and A. bogotensis extract notably reduced the contraction induced by PE whereas their inhibitory effect in rings contracted with KCl were lower. A. bogotensis ethanol extract showed a high capacity for reducing the PE pressor response (pD´2: 5.51) as well as total efficacy for relaxing rings previously precontracted with PE. The relaxant efficacy and potency of A. bogotensis extract against rings previously contracted with KCl were notably lower. L-NAME partly reverted the inhibitory effect of A. bogotensis. Aqueous, butanol and dichloromethane fractions gave inhibitory responses lower than that obtained with the ethanol extract. Phytochemical screening of A. bogotensis extract revealed the significant presence of flavonoid and triterpene metabolites. Conclusions: These results suggest that A. bogotensis elicits a smooth muscle relaxant effect related to the alpha-1 antiadrenergic mechanism. This response is partially NO dependent and seems to be due to interactions among active metabolites likely to be of flavonoid and/or terpenoid nature.

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“…LUTS (lower urinary tract symptoms) from benign prostatic hyperplasia is definitely one of the most common causes of disturbed sleep among those men who are lucky enough to live beyond 65+ years [11]. LUTS (frequent urge to empty the bladder, incomplete emptying, weak stream, nocturia, i.e.…”

Section: Older Men's Health Problems Cause Insomnia and Low Quality Omentioning

confidence: 99%

Low health related quality of life (QoL) in older adults is associated with chronic pain in women and with disturbed sleep in men

Breivik

2014

Scandinavian Journal of Pain

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Lower urinary tract symptoms in men

Cited by 51 publications

References 116 publications

Transitional Zone Index as a Predictor of the Efficacy of α-Blocker and 5α-Reductase Inhibitor Combination Therapy in Korean Patients with Benign Prostatic Hyperplasia

Transitional Zone Index as a Predictor of the Efficacy of α-Blocker and 5α-Reductase Inhibitor Combination Therapy in Korean Patients with Benign Prostatic Hyperplasia

ALPHA ANTIADRENERGIC EFFECT OF Achyrocline bogotensis EXTRACT (“Vira Vira”) IN ISOLATED RAT AORTIC RING

Low health related quality of life (QoL) in older adults is associated with chronic pain in women and with disturbed sleep in men

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