21 research outputs found
Efficacy and Safety of Once-daily Oxybutynin Patch in Patients with Overactive Bladder Who had Experienced Adverse Reactions Caused by Oral Antimuscarinic Drugs
Objectives:To evaluate the efficacy and safety of once-daily oxybutynin patch for overactive bladder (OAB) patients not tolerating oral antimuscarinic drugs. Methods:We prospectively investigated 43 OAB patients treated with once-daily oxybutynin patches for dry mouth and constipation due to oral antimuscarinic drugs. Results:Oxybutynin patch treatment for 8 weeks significantly improved the visual analogue scale scores for dry mouth and constipation;total score and subscore (mean number of urgency episodes and daily micturitions) for OAB symptoms;and King’s Health Questionnaire scores for social limitations, emotions and sleep/energy (P=0.016 and 0.001;0.008, 0.041 and 0.015;and 0.007, 0.003 and 0.026, respectively). The 3-day frequency volume chart showed significant improvement in hours of undisturbed sleep(P=0.011). Eight patients had adverse reactions at the application site and withdrew from the study, while others only developed mild erythema and pruritus. Conclusions:Oxybutynin patch reduces adverse reactions caused by oral antimuscarinic drugs
Efficacy of Tadalafil Add-on Treatment for Men with Lower Urinary Tract Symptoms Refractory to Alpha-1 Adrenoceptor Blockers
Introduction:To evaluate the efficacy and safety of once daily phosphodiesterase type 5 inhibitor(PDE5i) tadalafil as an add-on treatment for men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH/LUTS)refractory to an alpha 1-blocker(a1-blocker). Materials and Methods:This study enrolled men aged >50 years with BPH/LUTS and erectile dysfunction(ED) that were refractory to >3 months of a1-blocker. We defined “refractory” as an international prostate symptoms score (IPSS) of >8 and a maximum flow rate (Qmax) <15 despite in no space take of an a1-blocker. Patients with contraindications to phosphodiesterase-5 inhibitors;those with symptoms of other diseases that were difficult to differentiate from BPH/LUTS;and those with postvoid residual of >100 ml were excluded. Eligible patients received added-on treatment with tadalafil 5 mg/day for 12 weeks. Results:Tadalafil add-on treatment significantly improved the IPSS parameters in terms of total score(P<0.001), subscore for storage(P=0.001), subscore for voiding(P<0.001), and quality of life(P=0.002). The 3-day frequency volume chart showed significant improvements in mean number of daily nocturnal micturations(P=0.002), nocturnal polyuria index(P=0.001), and hours of undisturbed sleep(P=0.006). Five patients dropped out because of an adverse event:two with a headache, two with dizziness and one with dyspepsia. There were no serious adverse events. Conclusion:Tadalafil add-on treatment was effective for patients with BPH/LUTS and ED that were resistant to a1-blockers
ニョウカン シキュウ ナイマク ショウ ノ 1 レイ
症例は49 歳女性.左水腎症と骨盤内リンパ節腫大の精査目的で当院紹介.CT・MRI で左下部尿管に造影効果を認める凹凸不整な腫瘍病変を認め,逆行性尿管造影で左尿管の完全閉塞を認めた.自然尿及び洗浄尿の細胞診は陰性であったが,画像所見から左尿管癌と診断し左尿管全摘除術を施行した.病理組織診で尿管子宮内膜症と診断され,術後は合併症なく退院した.A 49-years-old woman with left hydronephrosis was referred to our hospital. Computed tomography and magnetic resonance imaging showed an irregular contrast enhanced mass of the ureter. A retrograde pyelography showed complete obstruction of the left ureter. Cytology of urine and irrigated ureteral urine were both negative for malignamt cells. Left ureteronephrectomy was performed under clinical diagnosis of the ureteral tumor. Pathological examination of surgical revealed endometriosis of the uteter. She was in good health at 6 months after the surgery with no evidence of recurrence
フククウキョウカ シュジュツ ショケン カラ ノ ジンウ ニョウカン イコウ ブ キョウサクショウ ノ ケイタイ ブンルイ ト ジュツゴ ケイカ
【目的】水腎症の原因である腎盂尿管移行部閉塞(Uretero-Pelvic Junction Obstruction;UPJO)の病因を形態的に分類し,患者背景,術後の経過との関連性について検討した.【方法】2009年3月から2013年4月までに獨協医科大学越谷病院で施行した腹腔鏡下腎盂形成術(Laparoscopic Pyeloplasty;LPP)38症例について検討した.術中所見とビデオの見直しから以下のように3つの病因に分類した.Type 1:血管による閉塞を有するもの.Type 2:肥厚した被膜が腎盂尿管を包み込むもの.Type 3:硬い被膜に包まれ尿管の屈曲,狭窄を認めるもの.上記病因と術前後における症状,腹部超音波所見および利尿レノグラムを用いて評価した手術成績について比較検討した.【結果】38症例を手術ビデオで見直した結果,Type 1は14例,Type 2は13例,Type 3は11例であった.小児症例はType 1の症例が少なく,Type 2およびType 3が多かった.各Typeでの術後の症状,腹部超音波所見,利尿レノグラムの改善率に有意差はなかった.【結語】UPJOの形態と年齢には関連を認めたが,術後成績には明らかな違いは認めなかった.Background:To analyze the relationship between the etiology of ureteropelvic junction obstruction (UPJO) and surgical outcomes using laparoscopic clear view during pyeloplasty. Method:Total 38 patients who underwent laparoscopic pyeloplasty by Anderson-Hynes technique from 2009 March to 2013 April at Dokkyo Medical University Koshigaya Hospital, were enrolled into the study. According to the structure of the ureteropelvic junction under the laparoscopic view UPJO was divided to 3 types, type 1 (n= 14):vascular causes of ureteral obstruction, type 2 (n= 14):the presence of adhesion around UPJ, type 3 (n= 11):the presence of angulation due to ureteral kinks or adhesion. The relationships between types of UPJO and surgical outcomes were analyzed.Results:Many of pediatric patient were included in type 2 and 3. Types of UPJO were not related to operation time, symptom, abdominal ultrasonography, and results of diuretic renogram.Conclusion:Most of pediatric patients with hydronephrosis had no vascular cause. There are no significant differences between each types and surgical success rate in patients underwent laparoscopic pyeloplasty
Efficacy of Tadalafil Add-on Treatment for Men with Lower Urinary Tract Symptoms Refractory to Alpha-1 Adrenoceptor Blockers
Efficacy and Safety of Once-daily Oxybutynin Patch in Patients with Overactive Bladder Who had Experienced Adverse Reactions Caused by Oral Antimuscarinic Drugs
Clinical efficacy and tolerability of two Japanese traditional herbal medicines, Hachimi-jio-gan and Gosha-jinki-gan, for lower urinary tract symptoms with cold sensitivity
We evaluated the efficacy and tolerability of Hachimi-jio-gan (HJG; 八味地黃丸 bā wèi dì huáng wán) and Gosha-jinki-gan (GJG; 濟生腎氣丸 jì shēng shèn qì wán), two traditional Japanese medicines, in 60 patients with lower urinary tract symptoms (LUTS) having cold sensitivity unresponsive to α1-blockers or antimuscarinic drugs. All patients received a mixture of HJG or GJG for 12 weeks in addition to α1-blockers or antimuscarinic drugs as add-on therapy. International Prostate Symptom Score, International Prostate Symptom Score–Quality of Life, Benign Prostatic Hyperplasia Impact Index, and the number of nocturnal voids were statistically much improved. However, there was no change in maximal urinary flow rate and post-void residual urine. Urinary 8-hydroxy-2-deoxyguanosine was statistically greatly improved from baseline after treatment in the HJG group compared to the GJG group. Adverse reactions were observed in 8.3% of patients, but all reactions were mild. Both HJG and GJG mixtures can serve as safe and effective potential therapeutic alternatives in patients with LUTS and cold sensitivity unresponsive to α1-blockers or antimuscarinic drugs. Additionally, HJG mixture was found to have anti-oxidative activity, and therefore further long-term clinical investigations are needed to examine its anti-aging effects in addition to its effect on urinary symptoms
Clinical efficacy and tolerability of Gosha-jinki-gan, a Japanese traditional herbal medicine, for nocturia
We evaluated the efficacy and tolerability of Gosha-jinki-gan (GJG; 濟生腎氣丸 jì shēng shèn qì wán) in 30 cases of nocturia (夜尿 yè niào) unresponsive to α1-blockers or antimuscarinic drugs. All patients received GJG extract powder (2.5 g) three times a day for 12 weeks as an add-on therapy to α1-blockers or antimuscarinic drugs. Subjective outcomes assessed by the International Prostate Symptom Score—quality of life, and the benign prostatic hyperplasia impact index and objective outcomes assessed by urinary frequency and the urine production rate at night showed significant improvement after treatment. Moreover, other objective outcomes assessed by maximum flow rates, postvoid residual, serum human atrial natriuretic peptide levels, and urinary 8-hydroxy-2′-deoxyguanosine levels did not change. Adverse events were observed in 10% of cases; however, these events were mild. GJG appears to be a safe and effective potential therapeutic alternative for patients with nocturia unresponsive to α1-blockers or antimuscarinic drugs. Further clinical investigations are required to elucidate the precise pathophysiologic mechanisms of GJG in nocturia
Effects of a supplement combining Pycnogenol® and l-arginine aspartate on lower urinary dysfunction compared with saw palmetto extract
Objectives: Lower urinary tract symptoms (LUTS) and sexual dysfunction (SDys) are common problems that affect quality of life (QOL) in elderly men. In addition to prescribed drugs, many over-the-counter medications including supplements are used to treat QOL diseases. Phosphodiesterase inhibitors are reported to be effective for both LUTS and SDys by increasing nitric oxide levels. French maritime pine bark extract Pycnogenol®, which is a potent nitric oxide donor, is reported to be effective for SDys. However, no reports have been published on whether it ameliorates LUTS.
Design: Open-labeled, randomized study. The effects of two supplements, Nokogiriyashi EX® containing 160 mg saw palmetto (SP) extract per tablet and Edicare® containing 10 mg of Pycnogenol®, 115 mg of l-arginine and 92 mg of aspartate (PAA) per tablet on International Prostate Symptom Score (IPSS), IPSS–QOL, Overactive Bladder Symptom Score (OABSS), International Index of Erectile Function 5 (IIEF5), Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), urinary 8-OHdG and uroflowmetry (UFM) of total 40 men with LUTS and SDys were examined.
Results: 19 subjects were instructed to take two tablets of SP, on the other 20 were on four tablets of PAA for 16 weeks. IPSS and IPSS–QOL showed statistically significant improvements in both groups. OABSS and IIEF5 were significantly improved in the PAA group. Conversely, ICIQ-SF, 8-OHdG and UFM did not change in either group.
Conclusions: PAA might be an effective therapeutic alternative for elderly patients with LUTS and SDys
Antioxidant cosupplementation therapy with vitamin C, vitamin E, and coenzyme Q10 in patients with oligoasthenozoospermia
Objective: Overproduction of reactive oxygen species results in oxidative stress, a deleterious process that damages cell structure as well as lipids, proteins, and DNA. Oxidative stress plays a major role in various human diseases, such as oligoasthenozoospermia syndrome. Materials and methods: We evaluated the effectiveness of antioxidant co-supplementation therapy using vitamin C, vitamin E, and coenzyme Q10 in men with oligoasthenozoospermia. Overall, 169 infertile men with oligoasthenozoospermia received antioxidant therapy with 80 mg/day vitamin C, 40 mg/day vitamin E, and 120 mg/day coenzyme Q10. We evaluated spermiogram parameters at baseline and at 3 and 6 months of follow-up. Results: Significant improvements were evident in sperm concentration and motility following coenzyme Q10 therapy. Treatment resulted in 48 (28.4%) partner pregnancies, of which 16 (9.5%) were spontaneous. Significant improvements in sperm cell concentration and sperm motility were observed after 3 and 6 months of treatment. Conclusions: Vitamin C, vitamin E, and coenzyme Q10 supplementation resulted in a significant improvement in certain semen parameters. However, further studies are needed to empirically determine the effect of supplementation on pregnancy rate