摘要:

Prazosin is well known to most physicians as an effective antihypertensive medication, but its therapeutic value in many cases of benign prostatic hyperplasia (BPH) may be unfamiliar to many. Prostate problems are among the most common medical conditions facing older men, with BPH appearing in more than 50% of men over the age of 50 years and in 90% of those over 80 years of age. About 10% of men over the age of 40 undergo surgery for the condition. Research in the past 15 years has revealed that smooth muscle contractions in the enlarged prostate are controlled by stimulation of the α1-receptors in the tissue. This discovery has provided the rationale for administering drugs to block the stimulation of the αpreceptors to relieve the obstructive and irritative symptoms of BPH. Prazosin was an early candidate for such medication because of its highly selective α1-blockade and its well-documented safety record. Early clinical trials yielded convincing evidence of prazosin’s effectiveness in reducing BPH symptoms, and the number of patients treated with prazosin for BPH now numbers in the several hundreds. In these trials, prazosin administered in doses from 1 mg to as high as 9 mg a day relieved obstructive and irritative symptoms, as well as improved flow rates and decreased urethral pressure. Overall, between 60 and 70% of treated patients can be expected to enjoy real benefits from prazosin the

ISSN:0042-1138    

DOI:10.1159/000282022

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Prazosin HCl was administered to 20 patients with urinary obstructions associated with prostatic hypertrophy. Significant reductions were recorded in the nighttime and the mean 24-hour urination frequencies. Patient-assessed symptoms diminished significantly, and uroflowmetry revealed significant increases in average and maximum urine flow rates. Residual urine volume decreased, the residual urine ratio declined, and bladder compliance tended to increase. The prazosin HCl therapy produced no significant effects on blood pressure or pulse rate, and no side effects appeared. The therapy was judged to be ‘extremely beneficial’ in 10%, ‘beneficial’ or better in 50%, and ‘marginally beneficial’ or better in 85% of all t

ISSN:0042-1138    

DOI:10.1159/000282023

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The spontaneous contractile force of muscle strips isolated from male rabbit urinary bladder dome (detrusor) and base (trigonal muscle) was dose dependently inhibited by isoproterenol, a non-specific beta-adrenoceptor agonist. The relaxant response to 10––6M isoproterenol in the detrusor muscle was completely blocked by butoxamine (10––4M), a selective beta-2-antagonist, and by propranolol (10––6M), a non-specific beta-antagonist, but not by metopronol (10––6 to 10––4M), a selective beta-1-antagonist. Relaxation of trigonal muscle induced by 10––6M isoproterenol was inhibited 30% by metoprolol (10––5M), 70% by butoxamine (10––4M), and 100% by propranolol (10––6M). Terbutaline, a selective beta-2-adrenoceptor agonist, also caused dose dependently a relaxant response in detrusor and trigonal muscle. The maximum relaxant responses to isoproterenol and terbutaline were significantly greater in detrusor than in trigonal muscle. Dobutamine, a relatively specific beta-1-adrenoceptor agonist, caused a small but significant relaxant response in trigonal, but no change in detrusor muscle. In trigonal muscle the relaxant response to dobutamine was less than that to terbutaline. Cyclic adenosine monophosphate accumulation in detrusor did not significantly increase after administration of dobutamine, but significantly increased after administration of terbutaline. On the other hand, not only terbutaline, but also dobutamine, markedly increased cyclic adenosine monophosphate accumulation in trigonal muscle. These findings are consistent with the detrusor having a greater density of beta-adrenoceptors than trigonal muscle and with the relaxant responses to beta-adrenoceptors being mediated by the beta-2-subtype in the detrusor and by both beta-1 – and beta-2-subtypes in trigonal muscle of the rabbit through cyclic

ISSN:0042-1138    

DOI:10.1159/000281650

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The opening contraction energy (Eop), i.e. the energy expended by the detrusor in the opening phase of micturition, was measured in 70 males (mean age 63 ± 9 years) with bladder outflow obstruction (compressive obstruction) due to benign prostatic hypertrophy. Significant correlations (p < 0.001) were found between Eop and the maximum external voiding power developed by the detrusor, Wext max (rs = ––0.57), between Wext max and the fraction of bladder volume voided, VV% (rs = 0.65), and between Eop and VV% (rs = ––0.77) – which suggests that increasing values of Eop affect the energy which the detrusor can supply for completion and termination of voiding. It then seems the parameter Eop would be able to assess not only the opening phase of micturition, but the emptying phase as well – the greater Eop (i.e. the greater the work needed to unfold the urethral lumen and start urine flow), the lesser the muscle mechanical capability of the urinary bladder to completely void. Thus, we eventually believe that calculating the parameter Eop may prove to be a complete, though indirect, method of quantifying the degree of prostatic (compressive) obstruction of the vesical outlet by a single num

ISSN:0042-1138    

DOI:10.1159/000281651

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Prazosin HCl was administered in dosages of 1.5–4.5 mg/day for 4 weeks to 40 patients suffering from dysuria accompanying prostatic hyperplasia. Significant reductions were observed in the mean frequency of night-time and 24-hour urination. Additionally, significant improvements were recorded for the time for start of urination, time from start to finish of urination and related variables. The improvements correlated with dosage levels. Objective variables measured by urine flow rates also exhibited significant improvement. A statistically significant decrease in systolic without a decline in diastolic blood pressure was observed. Slight dizziness was observed in 1 patient and elevated laboratory test values in another, but neither warranted discontinuation of the medication; however, 1 patient did have two doses of medication held. Overall, the drug was judged benefical to some degree in 95% of the patient

ISSN:0042-1138    

DOI:10.1159/000282025

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Among the number of urological symptoms in women complaining of incontinence more specific symptoms are often overlooked. Frequency, urge, suprapubic pain, nocturia, etc., are typical for bladder wall disorders, but also often misleading as part of the incontinence symptomatology. The final diagnosis of bladder wall diseases is based on biopsies from the bladder wall. It is noteworthy that the mucosa often looks normal at endoscopy. In this paper several types of abacterial cystitis will be presented to illustrate the difficulty in revealing the diagnosis of bladder wall disorders.

ISSN:0042-1138    

DOI:10.1159/000281652

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

In calcium oxalate urolithiasis, the monohydrate and dihydrate forms can be found. The aim of this paper is to examine a group of patients with calcium oxalate calculi to determine the calcium oxalate form and the possible relationship with calcium and other urinary biochemical parameters. It was found that calcium oxalate monohydrate is more frequent in the normocalciuric group and also is associated with a lack of inhibitory capacity, while a mixed calculus of calcium oxalate and phosphate or calcium oxalate dihydrate can be related with hypercalciuria.

ISSN:0042-1138    

DOI:10.1159/000281653

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The effects of α1-adrenergic blockade with prazosin HCl were examined in 28 patients with benign prostatic hypertrophy and bladder neck contracture. The patients received 2–3 mg of prazosin HCl daily administered orally. Improvement in subjective symptoms was observed in 75% of the patients. We evaluated clinical effects as the minimum time of micturition (calculated as the ratio of voided volume/maximum flow rate) for voided volumes less than 200 ml and the maximum flow rates and average flow rates for voided volumes over 200 ml. Evaluation of the findings on a flow rate nomogram revealed improvement in maximum flow rates and average flow rates in 41% of the patients. Side effects such as dizziness developed in only 1 patie

ISSN:0042-1138    

DOI:10.1159/000282026

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The kidneys of 30 rats were treated by extracorporeal shock wave lithotripsy (ESWL) with different doses of extracorporeal shock waves: 500, 1,000 and 2,000. The animals were sacrificed after 24 h, 7, 14 or 35 days. Magnetic resonance (MR) imaging at 1.5T was used to evaluate the effects of ESWL on T1- and T2-weighted (spin echo 600/22, 1,600–2,000/90) images compared to histology and macroscopy. The severity of pathologic changes correlated dose dependently with the number of shock waves given (500–2,000). The MR findings following ESWL in 50 kidneys included diffuse loss of the corticomedullary junction (n = 20), perirenal and subcapsular fluid (n = 23), intrarenal foci of increased (n = 16) or decreased (n = 8) signal intensity, and loss of distinction between renal, splenic or hepatic contours (n = 7), detected macroscopically as adhesions. Subcapsular and intrarenal findings corresponded to acute hematomas and organized fibrotic tissue morphologically. In long-term groups MR revealed fibrotic shrinkage of the renal convexity as indentation of the kidney surface (n = 12). MR imaging is a sensitive method for the detection of specific alterations following ESWL, especially intrarenal changes, which are important for possible long-term lesions after E

ISSN:0042-1138    

DOI:10.1159/000281654

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The effects of prazosin HCl on the urethral pressure profile (UPP) were studied in 14 patients with benign prostatic hyperplasia. Urethral pressure profilometry was performed 1 h after oral administration of 1 or 2 mg prazosin HCl. Functional profile and continence zone lengths were significantly reduced following administration of 1 or 2 mg prazosin HCl, as compared with the pretreatment lengths. The administration of 2 mg prazosin HCl resulted in a significant decrease in prostatic peak pressure, whereas the maximum urethral closure pressure exhibited an insignificant decrease. The results suggest that the effects of prazosin HCl on UPP were dose dependent within the range from 1 to 2 mg.

ISSN:0042-1138    

DOI:10.1159/000282027

出版商:S. Karger AG    

年代:1990

数据来源: Karger