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SARIKAYA K, İBİŞ MA. Is there any effect of alpha-adrenergic blocker usage in preventing febrile urinary tract infections after prostate biopsy? JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1138430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose: To investigate whether the use of long term alpha-adrenergic blockers before biopsy has an effect on preventing febrile urinary tract infections (FUI) secondary to biopsy in patients undergoing prostate biopsy due to elevated prostate specific antigen (PSA).
Material and Methods: The data of 2558 patients who underwent transrectal ultrasonography-guided prostate biopsy (TRUS+BX) due to elevated PSA in our clinic between January 2008 and July 2021 were analyzed retrospectively. The patients were divided into two groups as those who used alpha-blockers for a minimum of three months or longer before biopsy (Group 1) and those who did not use alpha-blockers before applying to the outpatient clinic (Group 2). Demographic data of the groups and post-biopsy FUI development rates were compared.
Results: It was observed that 1340 (52.4%) of the patients were using alpha-blockers (Group 1) and 1218 (47.6%) did not (Group 2). The median age of the patients in the pre-biopsy groups was similar [Group 1=68(IQR=9) years and Group 2=68(IQR=9) years, p=0.887]. There was no significant difference between the groups in terms of median prostate volume [Group1=57(31) ml and Group2=58(34)ml, p=0.199]. The median PSA value was found to be significantly higher in Group 1 than in Group 2 [ 10.50(5.40)ng/dl vs 10.35(6.80)ng/dl, p=0.026]. Postvoid residual urine volume (PVR) was found to be significantly higher in Group 2 [Group 1=40(30) ml and Group2=60(90) ml, p
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Affiliation(s)
- Kubilay SARIKAYA
- Sağlık Bilimleri Üniversitesi Keçiören Eğitim ve Araştırma Hastanesi,Ankara
| | - Muhammed Arif İBİŞ
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA KEÇİÖREN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI
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Gotoh D, Torimoto K, Morizawa Y, Hori S, Nakai Y, Miyake M, Fujimoto K. Efficacy and safety of dutasteride with tadalafil add-on therapy in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. BMC Res Notes 2022; 15:288. [PMID: 36064733 PMCID: PMC9446813 DOI: 10.1186/s13104-022-06183-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/27/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of add-on therapy with the phosphodiesterase type 5 inhibitor tadalafil in Japanese men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) treated with dutasteride. RESULTS Twenty-four patients were enrolled. The participants had a median age of 71.0 (64.8-73.0) years and a median prostate volume of 37.3 (29.7-41.8) mL as measured using transabdominal sonography. The efficacy indicators, such as International Prostate Symptom Score (IPSS), quality of life (QOL) score, night-time urinary frequency, and night-time maximum voided volume, improved significantly at 4 weeks, and the effects lasted until 24 weeks (IPSS: 9.5 vs. 17.0, QOL: 2.0 vs. 4.0, nocturia: 2.0 vs. 2.0, night-time maximum voided volume: 290.0 vs. 240.0 mL). Overactive bladder symptom score (OABSS) and sexual health inventory for men (SHIM) significantly improved at 12 weeks, and the effects lasted until 24 weeks (OABSS: 3.0 vs. 5.0, SHIM: 11.0 vs. 7.5). However, maximum urine flow and residual urine volume showed no improvement at any point. Adverse events occurred in two cases. Taken together, add-on therapy with tadalafil was effective for patients with LUTS/BPH resistant to dutasteride monotherapy. In addition, this therapy was not associated with severe adverse events.
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Affiliation(s)
- Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara, Japan
- Department of Urology, Hirao Hospital, Kashihara, Japan
| | | | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Japan
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Tanuma Y, Tanaka Y, Okamoto T. Cutoff level of prostate volume to predict the efficacy of α1-D/A adrenoceptor antagonist, naftopidil. Urol Ann 2021; 13:296-300. [PMID: 34421268 PMCID: PMC8343274 DOI: 10.4103/ua.ua_93_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/25/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: In lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) patients, prostate volume (PV) at baseline affects the improvement of International Prostate Symptom Score voiding symptoms (IPSS-VS) by naftopidil (NAF), but not total IPSS (IPSS-TS). To predict the efficacy of NAF, the PV cutoff point was examined using IPSS-VS. Materials and Methods: Seventy-seven patients with LUTS/BPH were administrated with NAF 50 mg/day for 4 weeks. Age, PV, IPSS, IPSS quality-of-life (IPSS-QoL), and maximum flow rate (MFR) were evaluated at baseline, and IPSS, IPSS-QoL, and MFR were evaluated after the treatment (at 4 weeks). Responders and nonresponders were divided by IPSS-VS at 4 weeks, and the PV cutoff point was calculated. Results: At baseline, the mean age and PV were 70.7 ± 8.2 years (range, 54–88 years) and 43.3 ± 24.5 mL (range, 20.6–141.7 mL), respectively. After 4 weeks, area under the receiver operating characteristic curve was largest in the patients with <4 points of IPSS-VS. The best standard value to evaluate the efficacy IPSS-VS at 4 weeks was 4 points for the NAF treatment, and the best PV cutoff point was 37.3 mL (sensitivity 60.5%, specificity 71.9%). Conclusions: PV at baseline was one of the predictive factors which affected the efficacy of NAF for IPSS-VS, and LUTS/BPH patients who had PV more than 37.3 mL indicated poor improvement of IPSS-VS, even if IPSS-TS was improved.
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Affiliation(s)
- Yasushi Tanuma
- Department of Urology, Hokkaido Social Welfare Association Hakodate Hospital, Hokkaido, Japan
| | - Yoshinori Tanaka
- Department of Urology, Hokkaido Prefectural Esashi Hospital, Hokkaido, Japan
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Zitoun OA, Farhat AM, Mohamed MA, Hamad MR, Aramini B, Haider KH. Management of benign prostate hyperplasia (BPH) by combinatorial approach using alpha-1-adrenergic antagonists and 5-alpha-reductase inhibitors. Eur J Pharmacol 2020; 883:173301. [PMID: 32592768 DOI: 10.1016/j.ejphar.2020.173301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/23/2022]
Abstract
Currently, the main available treatments for benign prostate hyperplasia (BPH) are alpha-1 adrenergic receptor antagonists (ARAs), 5-alpha reductase inhibitors (5-αRI), anticholinergics, and Phosphodiesterase-5 inhibitors. Recent studies support the combined therapy approach using ARAs with 5-αRI for lower urinary tract symptoms (LUTS) in BPH patients at risk of clinical progression. We aimed to review BPH management in select group of randomized controlled trials by combination therapy with ARAs and 5-αRIs compared to monotherapy with either drug with respect to the safety and efficacy. A total of 6 randomized controlled trials (RCTs) involving comparison of combination therapy with monotherapy using ARAs and 5-αRIs were retrieved from PubMed Central and reviewed for international prostate symptom score (IPSS), quality of life (QoL), post-residual urinary flow rate (PUF), and clinical progression. The results significantly favour the treatment group that received the combination therapy in comparison with the groups receiving monotherapy. However, outcome with regard to prostate volume showed insignificant improvement when the combination therapy is compared with 5- αRIs alone, rather than ARAs. In conclusion, combination therapy using ARAs and 5-αRI is better than monotherapy in the patients of BPH. Fixed dose combination (FDC), a type of combination, is also cost-effective and its side-effects profile resembles to that of monotherapy.
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Affiliation(s)
- Osama A Zitoun
- Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia.
| | | | - Mohamed A Mohamed
- Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia.
| | - Mohammad R Hamad
- Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia.
| | - Beatrice Aramini
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy.
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Yu ZJ, Yan HL, Xu FH, Chao HC, Deng LH, Xu XD, Huang JB, Zeng T. Efficacy and Side Effects of Drugs Commonly Used for the Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia. Front Pharmacol 2020; 11:658. [PMID: 32457631 PMCID: PMC7225336 DOI: 10.3389/fphar.2020.00658] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is the most common benign disease of the prostate gland and is caused by benign hyperplasia of the smooth muscle cells and stromal cells in this important gland. BPH is also the most common disease underlying lower urinary tract symptoms (LUTS). The incidence of BPH increases with age and affects more than half of all men 50 years or older. BPH mainly exerts effects on urinary function and can seriously reduce a patient's quality of life. At present, treatment for BPH aims primarily to improve the quality of life and reduce the risk of BPH-related complications. Pharmacological therapy is recommended for moderate-to-severe cases of LUTS that are suggestive of BPH. A range of drugs is currently available to treat this condition, including α1-adrenoceptor antagonists, 5α-reductase inhibitors (5-ARIs), phosphodiesterase type 5 inhibitors (PDE5Is), muscarinic receptor antagonists (MRAs), β3-adrenoceptor agonists, and plant extracts. Of these, the most commonly used drugs in the clinic are α1-adrenoceptor antagonists, 5-ARIs, and combination therapy. However, these drugs exert their effects via various mechanisms and are associated with adverse reactions. The purpose of this review is to provide current comprehensive perspectives on the mechanisms of action, efficacy, and adverse reactions associated with the drugs most commonly used for the treatment of BPH.
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Affiliation(s)
- Zhao-Jun Yu
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Medical Department of Graduate School, Nanchang University, Nanchang, China
| | - Hai-Lan Yan
- Department of Clinical Medicine, Xi'an Jiao Tong University Health Science Center, Xi'an, China
| | - Fang-Hua Xu
- Department of Pathology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Hai-Chao Chao
- Institute of Clinical Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Lei-Hong Deng
- Department of Ultrasound, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiang-Da Xu
- Medical Department of Graduate School, Nanchang University, Nanchang, China
| | - Jian-Biao Huang
- Medical Department of Graduate School, Nanchang University, Nanchang, China
| | - Tao Zeng
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Cataneo J, Córdova-Cassia C, Curran T, Alvarez D, Poylin VY. Rate of urinary retention after ileostomy takedown in men and role of routine placement of urinary catheter. Updates Surg 2020; 72:1181-1185. [PMID: 32342346 DOI: 10.1007/s13304-020-00763-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/10/2020] [Indexed: 11/28/2022]
Abstract
Ileostomy takedown has been proposed as one of the procedures where the placement of the catheters can be avoided, however, the rate of UR after ileostomy takedown is unknown. The aim of this study is to investigate the rate of UR after ileostomy takedown and the potential benefit of perioperative Tamsulosin. Retrospective cohort study of men undergoing ileostomy takedown after pelvic colorectal surgery between January 2009 and December 2016. A total of 100 patients were identified. The rate of UR after ileostomy takedown was high at 26%. There were no instances of urinary tract infection, however, most instances of UR were in patients who did not have catheter in surgery (96% vs. 4%, p = 0.044). Perioperative use of tamsulosin did not result in significant decrease in urinary retention. Rates of urinary retention after ileostomy takedown are high. Although not placing the catheter may be protective against urinary tract infections, patients should be counseled about the possibility of UR after ileostomy takedown.
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Affiliation(s)
- Jose Cataneo
- Department of Surgery Advocate Illinois Masonic Medical Center, University of Illinois, 836 W Wellington Ave, Chicago, IL, 60657, USA
| | - Carlos Córdova-Cassia
- Colon and Rectal Surgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, USA
| | - Thomas Curran
- Colon and Rectal Surgery, Medical University of South Carolina, 179 Ashley Ave, Charleston, SC, 29425, USA
| | - Daniel Alvarez
- Department of Radiology, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA
| | - Vitaliy Y Poylin
- Gastrointestinal Surgery Northwestern Medicine, Feinberg School of Medicine, 676 North St Clair Street, Suite 650, Chicago, IL, 60611, USA.
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Ichihara K, Masumori N, Iwasawa A, Taguchi K, Yamaguchi Y, Nishimura M, Sasamura H, Suzuki N, Haga K, Miyao N, Hirose T. Silodosin as second-line α-blocker monotherapy in patients with benign prostatic hyperplasia: A prospective observational study. Int J Urol 2018; 25:849-854. [DOI: 10.1111/iju.13757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Koji Ichihara
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Naoya Masumori
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | | | - Keisuke Taguchi
- Department of Urology; Oji General Hospital; Tomakomai Hokkaido Japan
| | | | | | - Hiroto Sasamura
- Department of Urology; Hokkaido Medical Center; Sapporo Hokkaido Japan
| | | | - Kazunori Haga
- Department of Urology; Sanjyukai Hospital; Sapporo Hokkaido Japan
| | - Noriomi Miyao
- Department of Urology; Muroran City General Hospital; Muroran Hokkaido Japan
| | - Takaoki Hirose
- Department of Urology; JCHO Hokkaido Hospital; Sapporo Hokkaido Japan
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Matsukawa Y, Takai S, Majima T, Funahashi Y, Kato M, Yamamoto T, Gotoh M. Two-year follow up of silodosin on lower urinary tract functions and symptoms in patients with benign prostatic hyperplasia based on prostate size: a prospective investigation using urodynamics. Ther Adv Urol 2018; 10:263-272. [PMID: 30116302 DOI: 10.1177/1756287218783646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 05/27/2018] [Indexed: 11/15/2022] Open
Abstract
Background The aim of this research was to investigate intermediate-term effects of silodosin on lower urinary tract functions and symptoms in patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) according to prostate size, using urodynamics. Methods A total of 70 untreated outpatients with a prostate volume <40 ml [small prostate (SP) group] and 70 with prostate volume ⩾40 ml [large prostate (LP) group] were prospectively enrolled and treated by monotherapy with silodosin for 24 months. Changes in parameters from baseline to 3 months and 24 months after silodosin administration were assessed based on LUTS, voiding and storage function. In addition, withdrawal rates of silodosin due to insufficient effects were compared between the two groups and factors to influence the withdrawal were investigated. Results The International Prostate Symptom Score (IPSS), bladder outlet obstruction index (BOOI), and detrusor overactivity (DO) improved significantly for the 2-year follow up in both groups as compared with the baseline. IPSS, BOOI and DO improved by 40.4%, 41.3%, and 48.1% in the SP group, 32.7%, 35.9%, and 34.4% in the LP group at 3 months, while, 44.3%, 43.5%, and 63.0% in the SP group, 22.6%, 21.1%, and 34.4% in the LP group at 24 months, respectively. Improvement rates in the IPSS and BOOI at 3 months were maintained until 24 months in the SP group, but decreased in the LP group. Storage function improvements continued in both groups for 2 years. Dropout rate due to unsatisfactory effects was significantly higher in the LP group (20% versus 8.6%). Maximum flow rate, BOOI, and intravesical prostatic protrusion had a significant influence on the withdrawal of silodosin treatment in the LP group. Conclusions Silodosin significantly improved lower urinary tract functions for 2 years in patients with LUTS/BPH, regardless of prostate size. However, LUTS and BOO improvements tended to decrease in patients with a large prostate (>40 ml) in the intermediate term.
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Affiliation(s)
- Yoshihisa Matsukawa
- The Department of Urology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Shun Takai
- The Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tsuyoshi Majima
- The Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhito Funahashi
- The Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Kato
- The Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tokunori Yamamoto
- The Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Momokazu Gotoh
- The Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Nemoto K, Suzuki Y, Kondo Y. Current work environments: What problems are being faced by Japanese urologists? Int J Urol 2018; 25:327-336. [PMID: 29332306 DOI: 10.1111/iju.13517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/24/2017] [Indexed: 01/20/2023]
Abstract
Computer technology has contributed to innovative progress in industrial infrastructures and has had a major influence on various work environments. Evaluations of work environments are routinely carried out in Western countries, but historically there has been resistance to such evaluations in Japan. In this mini-review, we discuss the current work environments of urologists in Japan. The number of urologists has increased each year, and the population density of urologists was 5.4 (per 100 000 people) in 2014. The average age of urologists in Japan was 48.9 years, and the percentage of female urologists was just 5.3%. Additionally, the geographic distribution of urologists was uneven in Japan. From projections based on population dynamics, the need for more urologists in the near future will probably increase. Because medical environments vary depending on the country, it is necessary to understand current work environments in greater detail initially. Furthermore, we should determine original measures for the establishment of satisfactory urological work environments in Japan.
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Affiliation(s)
- Kaoru Nemoto
- Department of Urology, Nippon Medical School, Chiba-Hokusoh Hospital, Chiba, Japan
| | - Yasutomo Suzuki
- Department of Urology, Nippon Medical School, Chiba-Hokusoh Hospital, Chiba, Japan
| | - Yukihiro Kondo
- Department of Urology, Nippon Medical School, Tokyo, Japan
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Homma Y, Gotoh M, Kawauchi A, Kojima Y, Masumori N, Nagai A, Saitoh T, Sakai H, Takahashi S, Ukimura O, Yamanishi T, Yokoyama O, Yoshida M, Maeda K. Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia. Int J Urol 2017; 24:716-729. [DOI: 10.1111/iju.13401] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/23/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Yukio Homma
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Momokazu Gotoh
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | | | - Yoshiyuki Kojima
- Department of Urology; Fukushima Prefectural University of Medicine; Fukushima Japan
| | - Naoya Masumori
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Atsushi Nagai
- Department of Urology; Kawasaki Medical School; Kurashiki Japan
| | | | - Hideki Sakai
- Department of Urology; Nagasaki University; Nagasaki Japan
| | | | - Osamu Ukimura
- Department of Urology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | | | | | - Masaki Yoshida
- Department of Urology; National Center of Geriatrics and Gerontology; Obu Japan
| | - Kenji Maeda
- Department of Urology; Maeda Clinic of Internal Medicine; Ageo Japan
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The Persistence of Silodosin Monotherapy and the Reasons for Withdrawal from Treatment of Previously Untreated Japanese Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia. Adv Urol 2017; 2017:4842025. [PMID: 28694823 PMCID: PMC5485276 DOI: 10.1155/2017/4842025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/10/2017] [Accepted: 05/15/2017] [Indexed: 12/13/2022] Open
Abstract
Objectives The persistence of silodosin and the reasons for withdrawal from treatment of previously untreated Japanese patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) were evaluated in real-life clinical practice. Methods A total of 81 previously untreated Japanese patients diagnosed with LUTS/BPH were treated with silodosin monotherapy and prospectively followed for 4 years. The persistence rate was estimated using the Kaplan-Meier method. If silodosin had to be terminated or a patient did not come to the hospital, the reason was determined. Results The 6-month, 1-year, 2-year, 3-year, and 4-year persistence rates were 63.0%, 56.8%, 50.6%, 44.4%, and 35.8%, respectively. The most frequent reason (22.2%) for withdrawal was symptom resolution. After silodosin treatment, the international prostate symptom score and the quality of life index were significantly improved and maintained for 4 years. Conclusions 35.8% of previously untreated Japanese patients continued silodosin for 4 years. Many patients terminated silodosin for various reasons, the most frequent of which was symptom resolution. The effects of silodosin were maintained when the patients continued treatment. Trial Registration This study was approved by the institutional review board of Hokkaido Prefectural Esashi Hospital (number 2007-2) and was registered in a public trial registry (UMIN000026910).
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Masumori N, Tsukamoto T, Shibuya A, Miyao N, Kunishima Y, Iwasawa A. Three-year outcome analysis of alpha 1-blocker naftopidil for patients with benign prostatic hyperplasia in a prospective multicenter study in Japan. Patient Prefer Adherence 2016; 10:1309-16. [PMID: 27524886 PMCID: PMC4966686 DOI: 10.2147/ppa.s110440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Our aim was to prospectively analyze the 3-year outcomes of naftopidil treatment for patients with benign prostatic hyperplasia (BPH), including those who dropped out during follow-up and had retreatment for BPH after termination of the drug within 3 years. PATIENTS AND METHODS Naftopidil, 50 mg/d or 75 mg/d, was given to 117 patients having BPH aged 50 years and older who had international prostate symptom scores (IPSS) ≥8. They were prospectively followed for 3 years with periodic evaluation. If naftopidil was terminated, the reason was determined. For patients with termination, an outcome survey was done to evaluate the status of retreatment for BPH at 3 years. RESULTS Twenty-five patients (21.4%) continued the same medication for 3 years. The total IPSS, quality of life index, BPH problem index, and maximum flow rate were significantly improved during 3 years. Treatment failure defined as symptomatic progression (an increase in the IPSS of ≥4 points compared to the baseline value), development of acute urinary retention, conversion to other α1-blockers, add-on of a 5α-reductase inhibitor, or conversion to surgery was observed in 41 patients (35.0%). In the univariate analysis, age, prostate volume, and serum prostate-specific antigen were predictors of treatment failure. Of the 50 patients who discontinued naftopidil during the follow-up, only 13 (26%) patients reported that they needed retreatment with α1-blockers and/or surgery within 3 years. CONCLUSION Long-term efficacy of naftopidil was observed, although older age, increased prostate volume, and elevated prostate-specific antigen at baseline were highly likely to result in treatment failure. Even after termination for various reasons, only a small portion of the patients needed retreatment for BPH within 3 years.
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Affiliation(s)
- Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo
- Correspondence: Naoya Masumori, Department of Urology, Sapporo Medical University School of Medicine, S1, W16, Chuo-ku, Sapporo 060-8543, Japan, Tel +81 11 611 2111, Fax +81 11 612 2709, Email
| | - Taiji Tsukamoto
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo
| | | | - Noriomi Miyao
- Division of Urology, Muroran City General Hospital, Muroran
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Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery. Int J Colorectal Dis 2015; 30:1223-8. [PMID: 26099320 DOI: 10.1007/s00384-015-2294-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 02/04/2023]
Abstract
PURPOSE Urinary retention is a common complication of pelvic surgery, leading to urinary tract infection and prolonged hospital stays. Tamsulosin is an alpha blocker that works by relaxing bladder neck muscles. It is used to treat benign prostatic hypertrophy and retention. We aim to investigate the potential benefits of preemptive tamsulosin use on rates of urinary retention in men undergoing pelvic surgery. METHODS This is a retrospective review of an institutional colorectal database. All men undergoing pelvic surgery between 2004 and 2013 were included. Patients given 0.4 mg of tamsulosin 3 days prior and after surgery at discretion of surgeon starting in 2007 were compared with patients receiving expectant postoperative management. RESULTS One hundred eighty-five patients were included in the study (study group: N = 30; control group: N = 155). Study group patients were older (56.8 vs. 50.1 years). Overall urinary retention rate was 22% with significantly lower rates in the study group compared with control (6.7 vs. 25%; p = 0.029). Study group had higher rates of minimally invasive surgery (61 vs. 29.7%); however, this did not impact urinary retention rate (20.6 vs. 22.7% for minimally invasive surgery vs. open surgery; p = 0.85). Independent predictors of urinary retention included lack of preemptive tamsulosin (odds ratio (OR), 7.67; 95% confidence interval (CI), 1.4-41.7) and cancer location in the distal third of the rectum (OR, 18.8; 95% CI, 2.1-172.8). CONCLUSIONS Preemptive perioperative use of tamsulosin may significantly decrease the incidence of urinary retention in men undergoing pelvic surgery. This may play a role in avoidance of urinary retention, particularly in patients with distal rectal cancer.
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Yamanishi T, Kaga K, Fuse M, Shibata C, Kamai T, Uchiyama T. Six-year follow up of silodosin monotherapy for the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: What are the factors for continuation or withdrawal? Int J Urol 2015; 22:1143-8. [DOI: 10.1111/iju.12915] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/03/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Tomonori Yamanishi
- Department of Urology; Continence Center; Dokkyo Medical University; Tochigi Japan
| | - Kanya Kaga
- Department of Urology; Continence Center; Dokkyo Medical University; Tochigi Japan
| | - Miki Fuse
- Department of Urology; Continence Center; Dokkyo Medical University; Tochigi Japan
| | - Chiharu Shibata
- Department of Urology; Continence Center; Dokkyo Medical University; Tochigi Japan
| | - Takao Kamai
- Department of Urology; Dokkyo Medical University; Tochigi Japan
| | - Tomoyuki Uchiyama
- Department of Neurology; Continence Center; Dokkyo Medical University; Tochigi Japan
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Effectiveness of Solifenacin and Trospium for Managing of Severe Symptoms of Overactive Bladder in Patients With Benign Prostatic Hyperplasia. Am J Mens Health 2015; 10:157-63. [DOI: 10.1177/1557988315595692] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research is aimed to study the possibility of management of severe symptoms of overactive bladder (OAB) with solifenacin and trospium in patients who receive treatment with tamsulosin due to benign prostatic hyperplasia (BPH). The 338 men more than 50 years old (average age 58.4 years) diagnosed with BPH and severe symptoms of OAB were enrolled in the study. Over three episodes of urinary incontinence per day (registration according to bladder diaries), International Prostate Symptom Score over 19, OAB-V8 questionnaire score over 32, and urodynamic disorders diagnosed using cystometry and uroflowmetry were taken as a criterion of severe symptoms of OAB. Patients of the main group during 2 months received treatment with daily combination of solifenacin 5 mg and trospium 5 mg simultaneously with tamsulosin 0.4 mg. Patients of the control group were treated only with tamsulosin. First endpoint is a quantitative assessment of patients with BPH having severe symptoms of OAB. Second endpoint is a state of the patients’ lower urinary tract after the treatment. In the main group, most of urodynamic indices normalized significantly. Number of episodes of incontinence reduced from middle level 3.4 (0.8) per day to 0.9 (0.7) per day. In the control group changes of urodynamic indices were not significant. Quantity of side effects did not exceed the level which is common for antimuscarinic monotherapy. Therefore, percentage of patients with severe symptoms of OAB is not less than 44% of all cases of prostatic hyperplasia accompanied by OAB symptoms. Combination of trospium and solifenacin in standard doses is an efficient and safe method of management of severe symptoms of OAB in the course of the treatment of with tamsulosin in patients more than 50 years of age.
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Fukuta F, Masumori N. A Review of Naftopidil for Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia. CURRENT BLADDER DYSFUNCTION REPORTS 2015. [DOI: 10.1007/s11884-015-0293-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Additional correction of OAB symptoms by two anti-muscarinics for men over 50 years old with residual symptoms of moderate prostatic obstruction after treatment with Tamsulosin. Aging Male 2015; 18:44-8. [PMID: 25136746 DOI: 10.3109/13685538.2014.951922] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To study the effectiveness and safety of combined standard-dosed Solifenacin and Trospium for management of symptoms of overactive bladder (OAB) in elderly patients after the treatment with Tamsulosin. PATIENTS AND METHODS A total of 417 men over 50 years of age (average age 57.9 (8.3)) with diagnosed prostatic obstruction (score 8-19 according to I-PSS), who had not taken Tamsulosin before, were enrolled in the study. I-PSS questionnaire (from 8 to 19 - moderate) and Awareness Tool questionnaire for evaluating OAB symptoms (total score for OAB symptoms over 8) were used at the beginning and at the end of the observation. Also, urodynamic parameters were examined. RESULT Percentage of patients with prevalent symptoms of obstruction of urethra decreases after the treatment with Tamsulosin and then rises again (36.2%), but absolute number of patients remains smaller than initial data. Percentage of patients with relative prevalence of symptoms of overactive bladder slightly increases against administration of Tamsulosin and reaches initial values at the time of administration of anti-muscarinic drugs with absolute decrease in number of such patients. CONCLUSION Combination of Trospium and Solifenacin is an effective way to manage residual symptoms of hyperactive bladder during treatment of early obstruction of urinary bladder.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, Far Eastern Federal University , Vladivostok , RUVVO Russian Federation
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Effect of Longbishu Capsule (癃闭舒胶囊) plus doxazosin on benign prostatic hyperplasia: A randomized controlled trial. Chin J Integr Med 2014; 20:818-22. [DOI: 10.1007/s11655-014-1844-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Indexed: 11/26/2022]
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Masumori N, Tsukamoto T, Horita H, Sunaoshi KI, Tanaka Y, Takeyama K, Sato E, Miyao N. Does Baseline Prostate Volume Affect the Short-Term Outcome of Tamsulosin? Low Urin Tract Symptoms 2014; 6:113-6. [PMID: 26663551 DOI: 10.1111/luts.12032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 07/24/2013] [Accepted: 07/28/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the short-term efficacy of tamsulosin treatment for patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) according to baseline prostate volume (PV). METHODS Tamsulosin, 0.2 mg/day, was prospectively given to 112 patients aged 50 years or older who had International Prostate Symptom Scores (IPSS) ≥ 8. The short-term efficacy was analyzed using the IPSS, quality of life (QOL) index, BPH problem index (BPI), maximum flow rate (Qmax ) and postvoid residual urine volume (PVR) at 4 weeks and 3 months after treatment considering the estimated PV at baseline. RESULTS Of the 112 patients, 81 and 31 had PV of < 35 and ≥ 35 mL, respectively. The IPSS was significantly improved in patients with PV of < 35 mL (17.8 ± 5.9 at baseline, 13.5 ± 7.0 at 4 weeks, 11.9 ± 6.1 at 3 months) and in those with PV of ≥ 35 mL (17.4 ± 6.7 at baseline, 13.1 ± 7.0 at 4 weeks, 13.4 ± 6.2 at 3 months). There was no significant difference in the changes of the IPSS between the groups in a combined analysis model (P = 0.559). In addition, the model revealed no significant differences in changes in the QOL index, BPI, Qmax and PVR. CONCLUSION The short-term efficacy of tamsulosin is observed irrespective of baseline PV. Thus, α1-blocker monotherapy should be considered for all patients with BPH/LUTS to rapidly relieve symptoms, although the long-term outcome is not promising for patients with a large PV at baseline.
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Affiliation(s)
- Naoya Masumori
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Taiji Tsukamoto
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hiroki Horita
- Division of Urology, Hokkaido Saiseikai Otaru Hospital, Otaru, Japan
| | - Ken-Ichi Sunaoshi
- Division of Urology, Hokkaido Social Insurance Hospital, Sapporo, Japan
| | - Yoshinori Tanaka
- Division of Urology, Hokkaido Prefectural Esahi Hospital, Esashi, Japan
| | - Koh Takeyama
- Division of Urology, Yakumo General Hospital, Yakumo, Japan
| | - Eiji Sato
- Division of Urology, Akabira City General Hospital, Akabira, Japan
| | - Noriomi Miyao
- Division of Urology, Muroran City General Hospital, Muroran, Japan
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Zhengyong Y, Changxiao H, Shibing Y, Caiwen W. Randomized controlled trial on the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention associated with benign prostatic hyperplasia. Scand J Urol 2014; 48:400-4. [DOI: 10.3109/21681805.2014.903512] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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