Validation of the combined medical therapy for LUTS using ai-adrenergic blockers and M-cholinoblockers


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Abstract

In the majority of patients, urination disorders are caused by both mechanical and functional factors. In patients with BPH timely determination of the type and nature of urinary dysfunction, especially bladder outlet obstruction and detrusor overactivity is of great practical importance. Without accounting for this factor, functional results of surgical treatment may be significantly impaired. a1-adrenergic blockers are the first-line therapy for men with moderate to severe lower urinary tract symptoms (LUTS). In selecting the appropriate therapy, more selective ш-adrenergic blockers should be chosen. The selectivity of the a1- adrenergic blockers provides high performance along with a favorable side effect profile especially regarding cardiovascular event rate. Like ш-adrenergic blockers, M-cholinoblockers have varying degrees of selectivity regarding the impact on the bladder. Solifenacin has greater selectivity for the bladder receptors than tolterodine and oxybutynin. The selectivity of this medication regarding the bladder manifests itself in the relatively low incidence of side effects, such as dry mouth, which enables the possibility of long-term therapy. Combined therapy with ш- adrenergic blockers and M-cholinoblockers may be considered as a treatment modality in patients with moderate to severe LUTS with a predominance of filling symptoms, especially if monotherapy proves not effective enough.

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About the authors

Z. K Gadzhieva

Urology Clinic, I.M. Sechenov First Moscow State Medical University

Email: gadzhieva-zaida@rambler.ru
Dr.Med.Sci., Urology Department, UCH №2

Yu. B Kazilov

Research Institute of Uronephrology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University

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