nach oben

International Urology and Nephrology

Erschienen in:

01.06.2012 | Urology - Original Paper

Long-term safety, tolerability, and efficacy of α1-adrenergic blocker in young men with primary bladder neck obstruction: Results from a single centre in China

verfasst von: Bing Li, Wansheng Gao, Chuanjiang Dong, Xiaomin Han, Shuqiang Li, Renfeng Jia, Chuanguo Xiao

Erschienen in: International Urology and Nephrology | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

Primary bladder neck obstruction (PBNO) is a nonneurogenic voiding disorder and frequently overlooked in young men. Prior studies have reported the efficacy of α-blockers only in the short-term for male patients with PBNO. We hereby report our long-term results using α1-blocker therapy in young men with PBNO.

Methods

Between January 2005 and December 2009, PBNO was diagnosed in 30 young men (mean age 27.3 years, range 18–35) at our institution. Doxazosin 4 mg once daily was administered for at least 12 months. Safety and tolerability were assessed, and efficacy was evaluated from International Prostate Symptom Score (I-PSS), Quality of Life (QOL), uroflowmetry, and post-void residual following 3- and 12-month treatment. Successful treatment was defined as at least 3 ml per second increase in the maximum flow rate and more than a 40% decrease in I-PSS.

Results

In all 30 patients, Mean symptom duration was 26.4 (3–65) months. The most common symptoms were hesitancy (93.3%), weak stream (76.7%), and frequency (66.7%). A total of 24 patients (80%, 24/30) successfully completed the 12 month of treatment. The medication period was 15.2 months, and follow-up duration was 16.3 months. Doxazosin was safe and well tolerated. The efficacy of doxazosin was maintained over the 12-month treatment period. Relative to baseline, there were reductions in the number of mean I-PSS (from 17.7 ± 4.2 to 10.4 ± 4.8), mean QOL (from 4.2 ± 1.1 to 2.4 ± 1.3), and mean post-void residual urine (from 79.3 ± 33.4 to 47.1 ± 21.3), and an increase in mean maximum flow rate (from 11.4 ± 2.9 to 15.1 ± 3.2 ml) after 12-month treatment. Treatment was successful in 16 patients (66.7%, 16/24) according to the improvement in both symptoms and maximum urine flow.

Conclusions

α1-blocker therapy displayed a favorable safety, tolerability, and efficacy profile during 12-month treatment in young male patients with PBNO.

Kaplan SA, Te AE, Jacobs BZ (1994) Urodynamic evidence of vesical neck obstruction in men with misdiagnosed chronic nonbacterial prostatitis and the therapeutic role of endoscopic incision of the bladder neck. J Urol 152:2063–2065PubMed

Webster GD, Lockhart JL, Older RA (1980) The evaluation of bladder neck dysfunction. J Urol 123(2):196–198PubMed

Donohoe JM, Combs AJ, Glassberg KI (2005) Primary bladder neck dysfunction in children and adolescents II: results of treatment with α-adrenergic antagonists. J Urol 173(1):212–216PubMedCrossRef

Turner-Warwick R, Whiteside CG, Worth PH et al (1973) A urodynamic view of the clinical problems associated with bladder neck dysfunction and its treatment by endoscopic incision and trans-trigonal posterior prostatectomy. Br J Urol 45(1):44–59PubMed

Padmanabhan P, Nitti VW (2007) Primary bladder neck obstruction in men, women, and children. Curr Urol Rep 8(5):379–384PubMedCrossRef

Lepor H (2007) Alpha blockers for the treatment of benign prostatic hyperplasia. Rev Urol 9(4):181–190PubMed

Nitti VW, Lefkowitz G, Ficazzola M et al (2002) Lower urinary tract symptoms in young men: videourodynamic findings and correlation with noninvasive measures. J Urol 168(1):135–138PubMedCrossRef

Yang SS, Wang CC, Hsieh CH et al (2002) Alpha1-adrenergic blockers in young men with primary bladder neck obstruction. J Urol 168(2):571–574PubMedCrossRef

Cisternino A, Zeccolini G, Calpista A et al (2006) Obstructive primary bladder neck disease: evaluation of the efficacy and safety of Alphal-blockers. Urol Int 76(2):150–153PubMedCrossRef

10.

Marion G (1933) Surgery of the neck of the bladder. B J Urol 5:351–357CrossRef

11.

Diokno AC, Hollander JB, Bennett CJ (1984) Bladder neck obstruction in women: a real entity. J Urol 132(2):294–298PubMed

12.

Kaplan SA, Ikeguchi EF, Santarosa RP et al (1996) Etiology of voiding dysfunction in men less than 50 years of age. Urology 47(6):836–839PubMedCrossRef

13.

Van Batavia JP, Combs AJ, Horowitz M et al (2010) Primary bladder neck dysfunction in children and adolescents III: results of long-term Alpha-blocker therapy. J Urol 183(2):724–730PubMedCrossRef

14.

Norlen LJ, Blaivas JG (1986) Unsuspected proximal urethral obstruction in young and middle-aged men. J Urol 135(5):972–976PubMed

15.

Toh KL, Ng CK (2006) Urodynamic studies in the evaluation of young men presenting with lower urinary tract symptoms. Int J Urol 13(5):520–523PubMedCrossRef

16.

Potts J, Payne RE (2007) Prostatitis: Infection, neuromuscular disorder, or pain syndrome? Proper patient classification is key. Cleve Clin Med J 74(Suppl1):S 63–S 71

17.

Schiller DS, Parikh A (2011) Identification, pharmacologic considerations, and management of prostatitis. Am J Geriatr Pharmacother 9(1):37–48PubMedCrossRef

18.

Gurunadha RT, Evans CP (2002) Management of prostatitis. Prostate Cancer Prostatic Dis 5(3):172–179CrossRef

19.

Nickel JC (1997) The pre and post massage test (PPMT): a simple screen for prostatitis. Tech Urol 3(1):38–43PubMed

20.

Gillenwater JY, Conn RL, Chrysant SG et al (1995) Doxazosin for the treatment of benign prostatic hyperplasia in patients with mild to moderate essential hypertension: a double-blind, placebo-controlled, dose-response multicenter study. J Urol 154(1):110–115PubMedCrossRef

21.

Fawzy A, Braun K, Lewis G et al (1995) Doxazosin in the treatment of benign prostatic hyperplasia in normotensive patients: a multicenter study. J Urol 154(1):105–109PubMedCrossRef

22.

Chapple CR, Carter P, Christmas TJ et al (1994) A three month double-blind study of doxazosin as treatment for benign prostatic bladder outlet obstruction. Br J Urol 74(1):50–56PubMedCrossRef

Titel: Long-term safety, tolerability, and efficacy of α1-adrenergic blocker in young men with primary bladder neck obstruction: Results from a single centre in China
verfasst von: Bing Li
Wansheng Gao
Chuanjiang Dong
Xiaomin Han
Shuqiang Li
Renfeng Jia
Chuanguo Xiao
Publikationsdatum: 01.06.2012
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 3/2012
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-011-0096-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Long-term safety, tolerability, and efficacy of α1-adrenergic blocker in young men with primary bladder neck obstruction: Results from a single centre in China