Résumé
Purpose: This study was performed to identify the effects of the alpha1A adrenoceptor antagonist on the urethral perfusion pressure (UPP), and also to assess its therapeutic potentials for female bladder outlet obstruction (BOO). Materials and Methods: A cannula was placed in the femoral artery for drug administration and systemic blood pressure monitoring in each female rat. The UPP and vesical pressure (Pves) were monitored using a triple-lumen catheter. Tamsulosin (group I), doxazosin (group II) and phentolamin (group III) were injected into female rats via the femoral cannula. Tamsulosin was also injected to male rats (group IV) for comparison with Group I. Results: After administration of tamsulosin in group I, the frequency was significantly decreased and the duration of minimal urethral relaxation with high frequency oscillations (Dhfo) was significantly prolonged. None of the parameters were significantly different compared with groups II and III, with the exception of the mean arterial blood pressure (MAP). The changes of MAP after tamsulosin were significantly lower than those after doxazosin and phentolamin. In the male rats (group IV), prior to the administration of tamsulosin, the UPP and Pves curves were similar to those of the female rats, but the maximal Pves was significantly higher than in group I. After the administration of tamsulosin to group IV, the prolongation of the frequency and Dhfo were significant. Conclusions: In the female rat urethra, the alpha1A adrenergic receptor may be a functional subtype. The alpha1A adrenoceptor antagonist was found to prolong the Dhfo and decrease the frequency of involuntary bladder contraction. It might be possible that the alpha1A adrenoceptor antagonist improves not only the obstructive symptoms, but the bladder irritative symptoms also, by prolonging the Dhfo and frequency of an involuntary bladder contraction.
Sujets)
Animaux , Femelle , Humains , Mâle , Rats , Antagonistes alpha-adrénergiques , Pression artérielle , Moniteurs de pression artérielle , Cathéters , Doxazosine , Artère fémorale , Perfusion , Récepteurs adrénergiques , Relaxation , Urètre , Vessie urinaire , Obstruction du col de la vessieRésumé
PURPOSE: We performed this study to elucidate whether patient`s satisfaction and improvement of clinical parameters after transurethral resection of prostate(TURP) correlate with the degree of preoperative obstruction. We investigated the role of urodynamic studies as a predictor of outcome after TURP. MATERIALS AND METHODS: Parameters including pre-operative symptom scores(IPSS), uroflow rate, prostate volume and urodynamic studies, were assessed in 27 patients undergoing TURP due to BPH. Bladder outlet obstruction was assessed by pressure-flow study(PFS). Post-operative evaluation was performed with IPSS and uroflowmetry 3 months after surgery. Post-operative patient`s satisfaction was determined by subjective responses to the questionnaires. The subjective responses, clinical and urodynamic parameters were compared and statistically analyzed. RESULTS: Eighteen patients(67%) had preoperative bladder outlet obstruction(BOO; defined as L-PURR> or =3), while 14(52%) demonstrated associated detrusor instability(DI). Significant improvements in IPSS, quality of life, peak flow rate and residual urine were noted in all patients post-operatively(p or =3) and 91%(L-PURR<3). CONCLUSIONS: No differences in the improvements of clinical parameters except voiding symptom scores were noted between obstructive and non-obstructive BPH. However, patient`s satisfaction after surgery was higher for patients in whom preoperative pressure-flow study confirmed obstruction. Also, obstructive parameters such as L-PURR or URA may be useful in predicting postoperative results.