비신경인성 여성 배뇨장애환자에서 4주간의 Doxazosin GITS의 효용성과 안정성: 단기 추적 결과
Efficacy and Safety of Doxazosin GITS over 4 weeks for the Treatment of Non-neurogenicVoiding Dysfunction in Females: Short-term Outcomes
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Abstract
Purpose: We administered doxazosin gastrointestinal therapeutic system (GITS) to women with non-neurogenic voiding dysfunction to evaluate its therapeutic effects. Materials and Methods: Women who had voiding dysfunctions for at least 3 mo were included. Inclusion criteria were age ≥18yr, an International Prostate Symptom Score (IPSS) ≥15, and a maximum flow rate (Qmax) <15mL/sec and/or postvoid residual (PVR) ≥150mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram. After 4 weeks, treatment outcomes were evaluated. Results: Sixty-two patients were evaluated of mean age 53.8 (32-78)yr. According to the Blaivas-Groutz nomogram, 24 patients had no or mild obstruction (group A) and 38 had moderate or severe obstruction (group B). After treatment, mean IPSS decreased significantly and by more than 5 points in 42 (67.7%). Mean bother scores, Qmax, and PVR also changed significantly. Thirty-seven (59.7%) showed Qmax increases of more than 50%. No significant difference were observed between the groups in terms of IPSS, bother score, Qmax, PVR, micturition frequencies, or functional bladder capacity changes. Adverse effects related to medication were de novo stress urinary incontinence (SUI) (1 case) and underlying SUI aggravation (1 case). By satisfaction assessments, 16 patients (25.8%) were 'mainly satisfied', 31 (50%) were 'slightly satisfied', and 15 (24.2%) were 'dissatisfied'. Conclusion: Doxazosin GITS was found to be effective in female patients with voiding dysfunction regardless of obstruction grade. The α-adrenoceptor antagonists should be viewed as initial treatment option for women with a non-neurogenic voiding dysfunction. (J Korean Continence Soc 2008;12:19-26)
참고문헌 (19)
- Groutz A., "Non-neurogenic female voiding dysfunction", Curr Opin Urol, 12, pp.311~316 (2002)
- Kessler TM., "The effect of terazosin on functional bladder outlet obstruction in women: a pilot study", J Urol, 176, pp.1487~1492 (2006)
- Pischedda A., "Use of alpha1-blockers in female functional bladder neck obstruction", Urol Int, 74, pp.256~261 (2005)
- Yamanishi T., "Combination of a cholinergic drug and an alpha-blocker is more effective than monotherapy for the treatment of voiding difficulty in patients with underactive detrusor", Int J Urol, 11, pp.88~96 (2004)
- Andersson KE., "Prostatic alpha1-adrenoceptors and uroselectivity", Prostate, 30, pp.202~215 (1997)
- Morita T., "Sex differences in function and distribution of alpha 1- and alpha 2-adrenoceptors in rabbit urethra", Am J Physiol, 252, pp.F1124~1128 (1987)
- Nasu K., "Quantification and distribution of alpha1-adrenoceptor subtype mRNAs in human proximal urethra", Br J Pharmacol, 123, pp.1289~1293 (1998)
- Yablonsky F, "Alpha 1- and alpha 2-adrenoceptors in the smooth muscle of male and female rabbit urethra", Eur J Pharmacol, 121, pp.1~8 (1986)
- Schafer W., "Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies", Neurourol Urodyn, 21, pp.261~274 (2002)
- Blaivas JG, "Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology", Neurourol Urodyn, 19, pp.553~564 (2000)
- Gerstenberg TC., "Lindenberg J. Spastic striated external sphincter syndrome imitating recurrent urinary tract infection in females. Effect of long-term alpha-adrenergic blockade with phenoxybenzamine", Eur Urol, 9, pp.87~92 (1983)
- Kawabe K, "Use of an alpha 1-blocker, YM-12617, in micturition difficulty", Urol Int, 42, pp.280~284 (1987)
- "Hinyokika Kiyo", 1991, 421~429
- Reitz A., "The effect of tamsulosin on the resting tone and the contractile behaviour of the female urethra: a functional urodynamic study in healthy women", Eur Urol, 46, pp.235~40 (2004)
- Abrams P., "Urodynamic effects of doxazosin in men with lower urinary tract symptoms and benign prostatic obstruction. Results from three double-blind placebo-controlled studies", Eur Urol, 32, pp.39~46 (1997)
- Cain MP., "Alpha blocker therapy for children with dysfunctional voiding and urinary retention", J Urol, 170, pp.1514~1515 (2003)
- Andersen M., "Double-blind trial of the efficacy and tolerability of doxazosin in the gastrointestinal therapeutic system, doxazosin standard, and placebo in patients with benign prostatic hyperplasia", Eur Urol, 38, pp.400~409 (2000)
- Roehrborn CG., "A double-blind placebo-controlled study evaluating the onset of action of doxazosin gastrointestinal therapeutic system in the treatment of benign prostatic hyperplasia", Eur Urol, 48, pp.445~452 (2005)
- Kumar A., "Management of functional bladder neck obstruction in women: use of alpha-blockers and pediatric resectoscope for bladder neck incision", J Urol, 162, pp.2061~2065 (1999)