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首页> 外文期刊>Urology >Urodynamic and clinical effects of terazosin therapy in symptomatic patients with and without bladder outlet obstruction: a stratified analysis.
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Urodynamic and clinical effects of terazosin therapy in symptomatic patients with and without bladder outlet obstruction: a stratified analysis.

机译：特拉唑嗪治疗有症状和无膀胱出口梗阻的有症状患者的尿动力学和临床效果：分层分析。

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OBJECTIVES: To evaluate clinical and urodynamic changes in patients with and without bladder outlet obstruction (BOO) and to compare the clinical and urodynamic results of terazosin treatment between patients with and without BOO. METHODS: In a prospective study, 97 patients who completed a full screening program including urodynamic investigation with pressure-flow study analysis started treatment with terazosin. A total of 60 patients completed 6 months of treatment and were re-evaluated with International Prostate Symptom Scores (IPSS), uroflowmetry, and urodynamic investigation with pressure-flow study analysis. Patients were stratified using the linear passive urethral resistance relation (lin-PURR) classification according to Schafer. Patients with a lin-PURR of 3 or more were classified as patients with BOO and patients with a lin-PURR of 2 or less were classified as patients without BOO. The clinical and urodynamic changes within and between the groups with and without BOO were evaluated. RESULTS: Terazosin resulted in significant symptomatic relief (9 points on the IPSS scale; P < 0.01) and a significant improvement of free urinary flow (3.0 mL/s; P < 0.01). In patients with BOO, a statistically significant improvement of all urodynamic obstruction variables (P < 0.01) was shown. In patients without BOO, a significant improvement of free urinary flow (4.4 mL/s; P < 0.01), a statistically significantly improved bladder capacity (increase of 70 mL; P = 0.01), and no statistically significant changes in urodynamic obstruction variables (P > 0.05) were shown. Patients with a hypoactive detrusor were more prone to early dropout. When comparing the changes of symptoms (P = 0.89), quality of life (P = 0.85), and the number of patients with improvements of free uroflow of at least 30% (P = 0.15), there appeared to be no significant difference between the groups with and without BOO. CONCLUSIONS: Although there is a statistically significant difference in urodynamic response to terazosin treatment between patients with and without BOO, we cannot recommend the use of pressure-flow studies in the selection of patients for terazosin treatment because the clinical results of treatment appear not to be significantly different between patients with and without BOO. It seems more useful, and certainly less expensive and less invasive, to start alpha 1-blocker therapy if, on clinical grounds, the urologist considers the patient to be a candidate for alpha 1-blocker therapy, and to continue therapy in those who respond.
机译：目的：评估有和没有膀胱出口梗阻（BOO）的患者的临床和尿动力学变化，并比较有和没有BOO的患者使用特拉唑嗪治疗的临床和尿动力学结果。方法：在一项前瞻性研究中，完成了包括尿动力学检查和压力流研究分析在内的完整筛查程序的97名患者开始使用特拉唑嗪治疗。共有60位患者完成了6个月的治疗，并通过国际前列腺症状评分（IPSS），尿流仪和压力动力学研究分析对尿流动力学进行了重新评估。根据Schafer使用线性被动尿道阻力关系（lin-PURR）分类对患者进行分层。 lin-PURR为3或更高的患者被分类为BOO患者，lin-PURR为2或更低的患者被分类为无BOO患者。评估有和没有BOO的组内和组之间的临床和尿动力学变化。结果：特拉唑嗪可显着缓解症状（IPSSS评分为9分; P <0.01），并且自由尿流量显着改善（3.0 mL / s; P <0.01）。在BOO患者中，所有尿动力学障碍变量均显示出统计学上的显着改善（P <0.01）。在没有BOO的患者中，游离尿流显着改善（4.4 mL / s; P <0.01），膀胱容量在统计学上显着改善（增加70 mL; P = 0.01），尿动力学障碍变量无统计学上的显着变化（ P> 0.05）。逼尿肌功能减退的患者更容易早期辍学。比较症状（P = 0.89），生活质量（P = 0.85）和游离尿流改善至少30％（P = 0.15）的患者数量的变化时，两者之间无显着差异。有和没有BOO的组。结论：尽管在有和没有BOO的患者之间，对特拉唑嗪治疗的尿动力学反应存在统计学上的显着差异，但是我们不建议在选择特拉唑嗪治疗的患者中使用压力流研究，因为治疗的临床结果似乎并不理想。有和没有BOO的患者之间存在显着差异。如果泌尿科医师根据临床理由认为患者是α1-受体阻滞剂的候选者，并继续对有反应的患者进行治疗，那么开始α1-受体阻滞剂的治疗似乎更有用，而且肯定会更便宜且侵入性更小。 。

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