The clinical effect of doxazosin mesylate, a selective long acting alpha-1 adrenergic blocker, were evaluated in 31 patients with symptomatic benign prostatic hyperplasia ranging from 49- 85 years old. All patients underwent a urodynamic evaluation and symptom score checking before enrollment into the study. The dose of doxazosin was 2mg per day. And the mean duration of treatment was 157 days. 31 patients were followed on doxazosin for 3 to 12 months with mean 7.5 months. The adverse drug reactions were observed only 1 case. The parameters used to assess the effectiveness of doxazosin included peak and mean urinary flow rates, micturition symptom scores and residual urine, and global assessment by the patient The peak and mean urinary flow rates increased by 77% and 86%, respectively. The obstructive and irritative symptom scores were improved by 51% and 41% respectively. The improvements in urinary flow rates and symptom scores were maintained for this interval. Although this preliminary experience with doxazosin is encouraging, the ultimate role of doxazosin for the long term treatment of benign prostatic hyperplasia needs further evaluation.
Adrenergic Antagonists ; Aged, 80 and over ; Doxazosin* ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Prostatic Hyperplasia* ; Urination ; Urodynamics

AIMTo evaluate the safety and efficacy of an extract of Ganoderma lucidum that shows the strongest 5alpha-reductase inhibitory activity among the extracts of 19 edible and medicinal mushrooms by a double-blind, placebo-controlled, randomized and dose-ranging study in men with lower urinary tract symptoms (LUTS).

METHODSIn this trial, we randomly assigned 88 men over the age of 49 years who had slight-to-moderate LUTS to 12 weeks of treatment with G. lucidum extract (6 mg once a day) or placebo. The primary outcome measures were changes in the International Prostate Symptom Score (IPSS) and variables of uroflowmetry. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, laboratory values and the reported adverse effects.

RESULTSG. lucidum was effective and significantly superior to placebo for improving total IPSS with 2.1 points decreasing at the end of treatment (mean difference, -1.18 points; 95% confidence interval, -1.74 to -0.62; P < 0.0001). No changes were observed with respect to quality of life scores, peak urinary flow, mean urinary flow, residual urine, prostate volume, serum prostate-specific antigen or testosterone levels. Overall treatment was well tolerated with no severe adverse effects.

CONCLUSIONThe extract of G. lucidum was well tolerated and improved IPSS scores. These results encouraged a further, large-scale evaluation of phytotherapy for a long duration using the extract of G. lucidum on men with LUTS.

Aged ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Ethanol ; Humans ; Male ; Middle Aged ; Phytotherapy ; Placebos ; Reishi ; Solvents ; Treatment Outcome ; Urination Disorders ; drug therapy ; Urodynamics ; drug effects

OBJECTIVETo study the efficacy and safety of Eviprostat for the treatment of benign prostatic hyperplasia (BPH).

METHODSAn open, multicentral clinical trial was conducted in 100 patients with BPH. Patients received a 12-week oral administration of Eviprostat 2 tablets per-time, 3 times a day. The main indexes of efficacy include international prostatic symptom score (IPSS), maximum urinary flow rate (Qmax), residual urine ( Ru) and prostatic volume (V). The additional indexes are quality of life score (QOL) and average urinary flow rate (Qave).

RESULTSAfter a 12-week therapy, IPSS, QOL score, Qmax and Qave were significantly improved. IPSS was averagely decreased by 5.67 (P < 0.001); QOL score was averagely decreased by 1.44 (P < 0.001); Qmax was averagely increased by 1.70 ml/s (P <0.001); Qave was averagely increased by 1.15 ml/s (P < 0.001); Ru was averagely decreased by 5.07 ml (P = 0.046) , PSA level was averagely decreased by 0.129 microg/L (P < 0.017). The clinical adverse event rate was 1%.

CONCLUSIONEviprostat is a kind of safe, effective and preferable drug for treating BPH. It can improve the subjective symptoms and objective measures of the patients.

Aged ; Aged, 80 and over ; Drug Combinations ; Ethamsylate ; adverse effects ; therapeutic use ; Humans ; Male ; Middle Aged ; Plant Extracts ; adverse effects ; therapeutic use ; Prostatic Hyperplasia ; drug therapy ; Quality of Life ; Treatment Outcome ; Urodynamics

PURPOSE: We determined the efficacy and safety of a relatively high dose of terazosin (5mg) in Korean patients with lower urinary tract symptoms (LUTS), with or without concomitant hypertension. MATERIALS AND METHODS: From July to December 2006, 200 men who consecutively presented with LUTS were prospectively studied. Eight weeks after treatment, blood pressure (BP), uroflowmetry, and International Prostate Symptom Score (I-PSS) were assessed. For analysis purposes, patients were stratified according to concomitant hypertension. Of the 200 patients, 173 completed the scheduled eight-week treatment period. RESULTS: At baseline, no differences were evident in the two groups in terms of I-PSS, Qmax, PVR and BP. After eight weeks of treatment-although I-PSS and uroflowmetry parameters were not significantly different in the two groups-systolic and diastolic BP in the non-hypertensive control group were higher than in the hypertensive group (p= 0.001 and p=0.0100, respectively). Changes in I-PSS, uroflowmetry parameters, and BPs measured at week eight post- treatment commencement did not significantly differ between the two groups. Moreover, the addition of 5mg of terazosin to antihypertensives did not cause a significant reduction in either systolic or diastolic BP in either group. CONCLUSION: Adding terazosin to existing antihypertensive regimens did not seem to increase the incidence of adverse events. Our findings suggest that 5mg terazosin is effective and that it has an acceptable safety profile as an add-on therapy for patients with LUTS and concomitant hypertension.
Adrenergic alpha-Antagonists/adverse effects/therapeutic use ; Aged ; Asian Continental Ancestry Group ; Blood Pressure/drug effects ; Humans ; Hypertension/complications/*drug therapy/physiopathology ; Korea ; Male ; Middle Aged ; Prazosin/adverse effects/*analogs & derivatives/therapeutic use ; Prospective Studies ; Prostate/drug effects/pathology ; Treatment Outcome ; Urodynamics/drug effects ; Urologic Diseases/complications/*drug therapy/ethnology

OBJECTIVEThis prospective randomized double-blinded clinical trial was designed to explore the effects of amlodipine and the combination of amlodipine with terazosin in improving postvoid residual (PVR) in patients with lower urinary tract symptoms (LUTS) and concomitant hypertension.

METHODSWe randomly divided 360 LUTS patients with concomitant hypertension into a 5 mg amlodipine group, a 2 mg terazosin group and a 5 mg amlodipine plus 2 mg terazosin group, and measured PVR at the baseline and 4 weeks after the treatment.

RESULTSFor male patients with LUTS associate with hypertension, all of amlodipine (APVR = 6.8) , terazosin (APVR = 7. 6), and combination group (APVR = 8.8) can significant reduced the PVR (P < . 0.1), but no significant difference was found among three groups.

CONCLUSIONAmlodipine alone or combined with terazosin can improve the PVR of the LUTS patient effectively, but had no significant difference compared with terazosin.

Adrenergic alpha-Antagonists ; therapeutic use ; Aged ; Amlodipine ; therapeutic use ; Antihypertensive Agents ; therapeutic use ; Double-Blind Method ; Drug Therapy, Combination ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Middle Aged ; Prazosin ; analogs & derivatives ; therapeutic use ; Prospective Studies ; Prostatic Hyperplasia ; complications ; drug therapy ; Treatment Outcome ; Urinary Retention ; complications ; drug therapy ; Urodynamics ; drug effects

To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged > or =18 yr with mixed nocturia (> or =2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4+/-44.1 to 220.3+/-90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia.
Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Antidiuretic Agents/*administration & dosage ; Deamino Arginine Vasopressin/*administration & dosage ; Drug Administration Schedule ; Female ; Humans ; Male ; Middle Aged ; Nocturia/complications/*drug therapy ; Polyuria/complications/*drug therapy ; Prospective Studies ; Questionnaires ; Sleep/drug effects/physiology ; Urinary Bladder/*physiopathology ; Urodynamics/physiology

Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.
Aged ; Anti-Bacterial Agents/therapeutic use ; Cystectomy/adverse effects ; Enterococcus/isolation & purification ; Escherichia coli/isolation & purification ; Female ; Humans ; Ileum/*surgery ; Incidence ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Reconstructive Surgical Procedures ; Retrospective Studies ; Risk Factors ; Urinary Bladder Neoplasms/*surgery ; Urinary Tract Infections/drug therapy/*epidemiology/etiology/microbiology ; Urodynamics