Efecto de la tamsulosina en la calidad de vida de pacientes con hiperplasia prostática benigna / The effect of tamsulosin in the quality of life of patients with benign prostatic hyperplasia

Resumen Introducción La hiperplasia prostática benigna es el padecimiento urológico más frecuente en hombres mayores de 50 años; sus síntomas afectan la calidad de vida. Los bloqueadores alfa-adrenérgicos son una opción para mejorarla. Objetivo Determinar la calidad de vida de pacientes con hiperplasia prostática benigna antes y después del tratamiento con un bloqueador alfa-adrenérgico. Material y métodos Estudio pretest-retest en hombres de 45 a 75 años con hiperplasia prostática benigna. Se administró tamsulosina (0.4 mg/día) por tres meses y se evaluó la severidad de los síntomas y la calidad de vida con el International Prostate Symptom Score (IPSS) y EuroQol 5-D. Se usaron X2 y prueba de rangos y signos de Wilcoxon. Resultados Se incluyeron 50 pacientes de 63.3 ± 10.3 años, 34 (68.0%) tenían síntomas severos antes del tratamiento y 19 (38.0%) después de tres meses (p < 0.05). Con el IPSS, 33 (66.0%) pacientes estaban en categorías de «tan insatisfecho como insatisfecho¼ a «muy insatisfecho¼ antes de la intervención y seis (12.0%) después de ella. La escala visual análoga (EVA) del EuroQol 5-D mostró puntuación basal de 72.9 ± 11.2 versus 83.4 ± 7.6 después (p < 0.05). Conclusión La tamsulosina reduce la severidad de los síntomas y mejora la calidad en de vida en la hiperplasia prostática benigna después de administrarla tres meses.

Abstract Introduction Benign prostatic hyperplasia is an urological disorder most common in men over 50 years old; the symptoms affect the quality of life. Alpha-adrenergic blockers are an option to improve it. Objective To determine the quality of life of patients with benign prostatic hyperplasia before and after treatment with an alphaadrenergic blocker. Material and methods Pretest-retest study in men of 45 to 75 years with benign prostatic hyperplasia. Tamsulosin was administered (0.4 mg/day) for three months; the severity of symptoms and quality of life were assessed with IPSS and EuroQol 5-D. Ranges and sign of Wilcoxon test and X2 were used. Results Fifty patients were included of 63.3 ± 10.3 years of age, 34 (68.0%) had severe symptoms before the treatment and 19 (38.0%) after three months (p < 0.05). With IPSS, 33 (66.0%) patients were in the categories of «as dissatisfied as unsatisfied¼ and «very dissatisfied¼ before the intervention and six (12.0%) after. The VAS of the EuroQol 5-D showed a baseline score of 72.9 ± 11.2 versus 83.4 ± 7.6 after (p < 0.05). Conclusion Tamsulosin reduces severity of symptoms and improves quality of life in benign prostatic hyperplasia after giving it three months.

Investigation of the Validity of an in vivo Experimental Model for the Evaluation of the Therapeutic Potentials of Drugs for the Treatment of Premature Ejaculation / 대한비뇨기과학회지

PURPOSE: The purpose of this study was to investigate the validity of in vivo experimental models to evaluate the therapeutic potentials of drugs for the treatment of premature ejaculation. MATERIALS AND METHODS: Male Sprague-Dawley rats (250-300gm) were divided into 8 groups based on the experimental agent administered: serotonergic agents (serotonin, clomipramine, fluoxetine, sertraline, paroxetine) and alpha-adrenergic blockers (prazosin, terazosin, tamsulosin). Various concentrations of the agents were intravenously injected 20 minutes prior to the electrical stimulation of the hypogastric nerve. Intraluminal pressures of seminal vesicle and vas deferens were measured on each side in the same animal. The concentration-response curves for each drug were obtained, and the inhibitory effects of the drugs on the contractile response of the seminal vesicles and vasa deferentia to the electrical stimulation of the hypogastric nerve were compared. RESULTS: All the serotonergic agents resulted in dose-dependent inhibition of the intraluminal pressure of the seminal vesicle to electrical stimulation (clomipramine>serotonin>fluoxetine>sertraline>paroxetine). The vasal pressure responses were also effectively inhibited by serotonin, clomipramine and sertraline, in that order. Fluoxetine and paroxetine showed no inhibitory effects on the vasal pressure. The pressure responses of both the seminal vesicles and the vasa deferentia were inhibited in a dose-dependent manner by all the alpha-adrenergic blockers. CONCLUSIONS: This in vivo model was not able to demonstrate the established clinical effects of various serotonergic agents widely used in the treatment of premature ejaculation. Conversely, the alpha-adrenergic blockers showed marked dose-dependent inhibition of the seminal tract pressure responses. Therefore, this in vivo model has limitations for the proper evaluation of therapeutic potentials of drugs for the treatment of premature ejaculation.

The Effect of Topical Dapiprazole on Phenylephrine and Tropicamide-induced Mydriasis

In order to evaluate the effect of topical dapiprazole, an alpha-adrenergic receptor blocker, in reversing mydrisis by 1% tropicamide and 2.5% phenylephrine, we studied 89 subjects. 0.5% dapiprazole in one eye of each subject after full dilatation of both pupils. The pupillary diameter was calibrated, and thereafter statistical analysis was performed with student paired t-test. Thirty minutes after instillation of dapiprazole, there was a highly significant difference of the decreasing rate in pupil size between the dapiprazole treated eyes and the control eyes(p<0.001). The time for complete reversal of mydriasis was also at least 4 hours shorter in the dapiprazole treated eyes than the control eyes(p<0.006). This study suggests that 0.5% dapiprazole is effective in reversing mydriasis caused by 1% tropicamide and 2.5% phenylephrine, and also effective in making the eyes comfortable in a shorter time.