A dosage regimen of M-receptor blocker after TURP for severe BPH with predominant urine storage symptoms / 中华男科学杂志

Objective@#To study the dosage regimen of oral M-receptor blocker following transurethral resection of the prostate (TURP) for severe benign prostate hyperplasia (BPH) with predominant urine storage period symptoms (USPSs) and its clinical effect.@*METHODS@#Severe BPH patients with predominant USPSs received oral tolterodine (2 mg q12d or 4 mg qd) 6 hours after TURP for 4 weeks. The medication continued for another 2 weeks in case of recurrence of USPSs or until the 12th week in case of repeated recurrence. Before and at 1, 4, 8 and 12 weeks after TURP, we analyzed the International Prostate Symptoms Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR) of the patients.@*RESULTS@#Complete clinical data were collected from 106 cases, of which 33 achieved successful drug withdrawal with no aggravation of USPSs at 4 weeks after TURP, 51 at 6－8 weeks, 13 at 10－12 weeks, and 9 needed medication after 12 weeks. Before and at 1, 4, 8 and 12 weeks after TURP, the total IPSSs were 25.33 ± 3.45, 19.33 ± 3.62, 11.56 ± 2.45, 8.38 ± 2.0 and 7.74 ± 1.87, those in the urine storage period were 11.97 ± 1.53, 10.76 ± 1.82, 6.16 ± 1.22, 4.08 ± 1.19 and 3.91 ± 1.15, those at urine voiding were 9.80 ± 1.60, 5.59 ± 1.45, 3.40 ± 0.92, 2.85 ± 0.71, and 2.61 ± 0.67, and the QoL scores were 4.70 ± 0.78, 3.92 ± 0.75, 2.55 ± 0.74, 1.83 ± 0.72 and 1.66 ± 0.75, respectively, with statistically significant differences between the baseline and the scores at 1 and 4 weeks (P 0.05). Qmax and PVR were improved progressively and significantly at 1 and 4 weeks (P 0.05).@*CONCLUSIONS@#Four to eight weeks of oral administration of M-receptor blocker may be an effective dosage regimen for severe BPH with predominant USPSs after TURP.

Therapy of refractory overactive bladder by Solifenacin for in children with lower urinary obstruction: 1 case report and literature review / 中华泌尿外科杂志

Objective To investigate the efficacy and safety of Solifenacin for the treatment of overactive bladder in children. Methods A retrospective analysis was done in a children admitted to our hospital in January 2010,with lower urinary tract obstruction lead to overactive bladder.The boy was 4 years old,suffering from difficult urinating,urinary frequent,urgency and incontinence for 4 years.Imaging studies (B ultrasound,intravenous urography,CT,bladder voiding urethrography) found bilateral hydronephrosis and kidney collecting system separation with left 3.3 cm and right 2.3 cm in diameter; ureteral dilation with left 1.3 cm,right 1.6 cm in diameter.A transverse septum crossing the urethra at a right angle distal to the verumontanum was detected.According to history,physical examination and imaging examination,a diagnosis for posterior urethral valves was established.Under general anesthesia,urethroscopy found that the valve was attached below urethra wall,divided into two forks towards urethral lateral wall.The valve was excised.Three months later,although good voiding,the hydronephrosis and hydroureter still did not improve.After cystostomy and 6 months follow-up,hydronephrosis and hydroureter still not improved. B ultrasound showed the renal pelvis dilation with left 3.2 cm,right 2.0 cm in diameter,and bilateral ureteral dilation with left 1.3 cm,right 1.4 cm in diameter.Solifenacin (5 mg/tablet),1/3 tablet,about 1.7 mg per day was added. Results After oral Solifenacin one month,hydronephrosis and hydroureter began to improve.After 3 months,hydroureter disappeared; hydronephrosis improved significantly.. B-ultrasound showed the renal collecting system mild dilation with left 1.1 cm,right 1.0 cm in diameter.After 13 months follow-up,no side effects was detected. Conclusions Combined with the surgical treatment,Solifenacin can alleviate hydronephrosis secondary to OAB,and can also protect the renal function.