Drug treatment for lower urinary tract symptoms.
10.5124/jkma.2011.54.6.637
- Author:
Ji Yeon HAN
1
;
Myung Soo CHOO
Author Information
1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mschoo@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Benign prostatic hyperplasia;
Drug treatment;
Overactive bladder
- MeSH:
Atrophy;
Azasteroids;
Contracts;
Deamino Arginine Vasopressin;
Dutasteride;
Humans;
Lower Urinary Tract Symptoms;
Muscarinic Antagonists;
Muscle, Smooth;
Nocturia;
Polyuria;
Prostatic Hyperplasia;
Receptors, Muscarinic;
Urinary Bladder;
Urinary Bladder, Overactive;
Urinary Incontinence, Urge;
Vasopressins
- From:Journal of the Korean Medical Association
2011;54(6):637-645
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Lower urinary tract symptoms (LUTS) are classified into three groups: storage, voiding, and post-micturition symptoms. The most popular causes of LUTS are benign prostatic hyperplasia (BPH) and overactive bladder (OAB). Although BPH is a pathologic term, clinically, we use this when patients have LUTS due to benign prostatic enlargement and obstruction. OAB is defined as urgency, with or without urge incontinence, usually with frequency and nocturia. Currently alpha1-adrenoceptor antagonists are the most common drug treatment for BPH, and are thought to act by relaxing the prostatic smooth muscle. They are all effective for the treatment of LUTS/BPH. 5alpha-reductase inhibitors, such as fiansteride and dutasteride, are another treatment option for BPH symptoms, which reduce the prostatic volume by inducing epithelial atrophy. Long-term combination therapy with alpha-1-blockers and 5alpha-reductase inhibitors reduces the risk of the overall clinical progression of BPH significantly more than does treatment with either drug alone. Antimuscarinics are the mainstay for the treatment of OAB. Antimuscarinics competitively block muscarinic receptors of all subtypes but with variations in selectivity for the different subtypes. When they are used for the treatment of OAB, they are active during the storage phase of the bladder, with little or no effect on voiding contractions. Desmopressin acetate is a synthetic analogue of Arginin vasopressin, which has been proven effective for the treatment of nocturnal polyuria in LUTS.
