Natural course of lower urinary tract symptoms following discontinuation of alpha-1-adrenergic blockers in patients with benign prostatic hyperplasia
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概要
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<p>alpha 1-adrenergic blockers (alpha b) remain the first-line therapy in men with lower urinary tract symptoms (LUTS). The current published work advocates continued use of alpha b for their effect to be maintained. However, some patients decide to discontinue use of the medication after their symptoms are relieved and can keep good conditions. In this study, we investigated the natural course of LUTS after the discontinuation of successful treatment of alpha b. Methods: Among 75 patients with LUTS who stopped alpha b medication once their symptoms improved, 60 patients (age, 50-87 years; median, 70) who could be followed for at least 12 months after discontinuation of alpha b were analyzed in this study. Evaluations included a clinical determination of the International Prostate Symptom Score (IPSS), peak flow rate (Qmax) and postvoid residual urine volume (PVR). Upon patient request or in cases of PVR more than 100 mL, administration of alpha b was resumed. Results: Eighteen out of the 60 patients (30%) asked for re-treatment within 12 months after discontinuation (re-treatment group). The other 42 patents were able to maintain good condition without medication (discontinuation group). The IPSS was 15.9, 8.7, 10.1, 10.2, 9.7, 8.8 and 9.0, on the first visit, just before discontinuation, and 1, 3, 6, 9 and 12 months after stopping treatment among the discontinuation group, respectively. Similarly, Qmax was 10.6, 14.8, 14.2, 14.3, 14.7, 13.2 and 13.6 mL/ s, respectively. Treatment periods, prostatic volume and peak flow rates just before discontinuation of medication differed significantly between the re-treatment and discontinuation group. Conclusions: In spite of the short follow-up periods, these results suggest that selected patients with relatively small prostatic volume and good flow rates after therapy can discontinue alpha b medication after their symptoms improve.</p>
- 2007-07-01
著者
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永井 敦
日本大学
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永井 敦
日本大学生産工学部
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Watanabe Toyohiko
Department of Urology, Thomas Jefferson University
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KUMON Hiromi
Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical
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Saika Takashi
Department of Urology, Okayama University Graduate School of Medicine
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Nasu Yasutomo
Department of Urology, Okayama University Graduate School of Medicine
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NAGAI Atsushi
Department of Internal Medicine-1, Tokyo Women's Medical University
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Satoh Takefumi
北里大学 医学部泌尿器科学
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Maki Yoshio
Department Of Urology Kawasaki Medical School
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Maki Yoshio
姫路聖マリア病院 泌尿器科
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Miyaji Yoshiyuki
Department of Urology, Kawasaki Medical School
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Yokoyama Teruhiko
Department of Urology, Kawasaki Medical School
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Yokoyama Teruhiko
川崎医科大学 泌尿器科学
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Yokoyama Teruhiko
Department Of Urology Graduate School Of Medicine Dentistry And Pharmaceutical Science Okayama Unive
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Yamato Toyoko
Department Of Urology Kawasaki Medical School
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Miyaji Yoshiyuki
川崎医科大学 泌尿器科
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Miyaji Yoshiyuki
Department Of Urology Kawasaki Medical School
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Saika Takashi
Department Of Urology Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical Sc
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Suyama Takahito
Department Of Urology Graduate School Of Medicine Chiba University
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Saika Takashi
Department Of Urology Nagoya University Graduate School Of Medicine
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Nagai Atsushi
Department Of Urology Kawasaki Medical School
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Nasu Yasutomo
Department Of Urology Okayama University Graduate School Of Medicine
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Nasu Yasutomo
Department Of Urology Okayama University Graduate School Of Medicine And Dentistry
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Kawamori Hiroyuki
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
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Konaka Hiroyuki
Department Of Integrative Cancer Therapy And Urology Kanazawa University Graduate School Of Medical
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Yoneyama Takahiro
Department of Urology, Hirosaki University Graduate School of Medicine
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Kumon Hiromi
Department Of Urology Graduate School Of Medicine Dentistry And Pharmaceutical Science Okayama Unive
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Nasu Yasutomo
川崎医科大学 泌尿器科学
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Saika Takashi
川崎医科大学 泌尿器科学
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Maeda Yuji
Department Of Integrative Cancer Therapy And Urology Kanazawa University Graduate School Of Medical
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Shimomura Tatsuya
Department Of Urology Jikei University School Of Medicine
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Watanabe Toyohiko
Department Of Urology Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical Sc
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Watanabe Toyohiko
Department Of Urology Okayama University Graduate School Of Medicine
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Kubo Hiroyuki
Department Of Urology Graduate School Of Medical And Dental Sciences Kagoshima University
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TAKAHASHI Satoru
Nihon University
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Tatarano Shuichi
Department Of Urology Graduate School Of Medical And Dental Sciences Kagoshima University
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Kumon Hiromi
Department Of Urology Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical Sc
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Yoneyama Takahiro
Department Of Urology Hirosaki University Graduate School Of Medicine
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Monura Yoshio
Department Of Urology Medical College Of Oita
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Nasu Yasutomo
Department Of Urology Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical Sc
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Matsukawa Yoshihisa
Department Of Urology Nagoya University Graduate School Of Medicine
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Kumon Hiromi
Department Of Urology Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical Sc
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Nagai Atsushi
Department Of Neurology Hematology & Rheumatology Shimane University Faculty Of Medicine
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Nagai Atsushi
Department Of Internal Medicine-1 Tokyo Women's Medical University
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Yoshikawa Masahiro
Department Of Urology Faculty Of Medicine Kyushu University
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Kumon Hiromi
Department Of Microbiology Okayama University School Of Medicine
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Saika Takashi
Department of Basic Engineering in Global Environment, Faculty of Engineering, Kogakuin University
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Nagai Atsushi
Department of Innovative and Engineered Materials, Tokyo Institute of Technology, J2-43, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8502, Japan
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