Alpha-1 blockers and detrusor overactivity in patients with prostate adenoma

Danilov, V. V.; Osinkin, K.S.; Sevryukov, F A

doi:10.20953/2307-6631-2018-2-49-53

Cited by 6 publications

(2 citation statements)

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“…В пожилом возрасте заметную роль начинает играть нейрогенный мочевой пузырь (НМП), что в сочетании с инфравезикальной обструкцией (ИВО) существенно ухудшает результаты оперативного вмешательства, усугубляет течение инфекций мочевой системы, приводит к почечной недостаточности [10][11]. Альфа1адреноблокаторы (А1АБ) не в состоянии изменить степень обструкции, поэтому для решения данной проблемы активно используются ингибиторы 5-альфаредуктазы [12].…”

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Features of Tactics for the Management of Patients of the Elderly Age With Benign Prostatic Hyperplasia

Danilov¹,

Остобунаев²,

Clinic³

2019

BSP

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The article presents the features of the tactics of conservative management of elderly patients with benign prostatic hyperplasia (BPH). A group of men with benign prostatic hyperplasia (32 patients), whose mean age was 67 years old, was under observation. The total duration of conservative treatment and follow-up ranged from 1.5 to 4 years. The scope of the preliminary examination included an extended biochemical test, all patients underwent 2-day uroflow monitoring, ultrasound examinations of the urinary system, measurement of the size of the prostate and residual urine. The efficiency of conservative combination therapy was evaluated using the IPSS table, urination diaries and home uroflow monitoring. As a result of the treatment with 5-alpha-reductase, alpha1-blockers, lipoic acid and vitamins, there was a significant decrease in the severity of clinical symptoms and leveling of dysfunction of the lower urinary tract.

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Features of Tactics for the Management of Patients of the Elderly Age With Benign Prostatic Hyperplasia

Danilov¹,

Остобунаев²,

Clinic³

2019

BSP

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“…Успехи консервативной фармакотерапии, ставшей первой линией терапии в лечении ДГПЖ, с одной стороны, позволили избежать хирургического вмешательства у части пациентов, а с другой стороны, привели к увеличению возраста оперируемых больных, а также удельному росту осложненных форм ДГПЖ [2,17]. Одним из своеобразных проявлений успехов фармакотерапии стало появление в практике урологов достаточно большого количества пациентов с «большими», «очень большими» и «гигантскими» объемами предстательной железы [8,9,14,15].…”

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Comparative Analysis of Transusrethral Bipolar Resection and Enucleation in Benign Prostatic Hyperplasia in Combination With Cystolithotripsia

Korotaev¹,

Zubkov²,

Goloviznin³

et al. 2019

BSP

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The article presents the results of the transurethral endoscopic treatment of patients with benign prostatic hyperplasia (BPH) and patients with BPH in combination with bladder stones. The retrospective analysis included 266 patients with benign prostatic hyperplasia for the period from 2017 till 2018. All patients were divided into groups according to the treatment option used for BPH (TURis or TUEB) and the presence or absence of simultaneous cystolithotripsia. The study demonstrated a statistically significant increase in the duration of surgical intervention, as well as an increase in the number of perioperative complications in the group of patients with cystolithotripsia. The timing of the removal of the urethral catheter and the duration of the postoperative stationary period did not differ between the compared groups.

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Features of compensatory and adaptive reactions of the vascular bed of the bladder of elderly and senile men with prostatic hyperplasia

Shormanov

Куликов

Solovyov

2022

Urology reports (St. - Petersburg)

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BACKGROUND: Bladder outlet obstruction caused by prostatic hyperplasia eventually leads to detrusor working hypertrophy, and its development is impossible without synchronous remodeling of its vascular bed. Taking into account the age-associated nature of the disease, bladder transformation occurs following involutive structural changes of both the organ and its vascular system due to natural aging. To date, morphological features of compensatory reactions of the vascular bed, taking into account background age-related changes in the bladder wall, is not fully disclosed. AIM: To investigate the structural transformations of the bladder and its vascular bed in elderly and senile persons with prostatic hyperplasia and to determine the significance of vascular restructuring in providing compensatory detrusor hypertrophy. MATERIALS AND METHODS: Autopsy material from 35 men aged 6080 years who died from diseases not related to urological and cardiovascular pathology was examined, as well as those from 25 men of the same age who had prostatic hyperplasia without signs of bladder decompensation. The control group included 15 men aged 2030 years who died as a result of injuries. A complex of histological, morphometric and immunohistochemical methods was used RESULTS: In patients with prostatic hyperplasia, there is a violation of the histoarchitectonics of the bladder, which is expressed in the development of focal detrusor hypertrophy, layering on the existing involutive changes, which are characterized by the atrophy of muscle fibers, sclerosis of the intermuscular stroma, defragmentation of the elastic frame, and neurodegenerative processes. A similar state of the detrusor is caused by sclerosis and hyalinosis of small arteries and arterioles, hypertrophy and hyperelastosis of large arteries associated with arterial hypertension, combined with atherosclerosis of extraorganic arteries. Moreover, a complex is formed in the vascular basin of the bladder that can regulate blood transport in conditions of increasing chronic ischemia and provide a normal blood supply to the preserved parts of the detrusor that can undergo hypertrophy with an increase in functional impairment. These structures include intimate muscles, muscular elastic sphincters, polypoid cushions of the conti arteries, muscle couplings, muscle rollers, and vein valves. CONCLUSIONS: Structural changes in the bladder are characterized by a combination of focal detrusor atrophy resulting from angiosclerosis and development of hypertrophy of preserved areas with an increase in functional load. The hypertrophic potential of the detrusor is attributed to vascular regulatory structures.

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Alpha-1 blockers and detrusor overactivity in patients with prostate adenoma

Cited by 6 publications

References 0 publications

Features of Tactics for the Management of Patients of the Elderly Age With Benign Prostatic Hyperplasia

Features of Tactics for the Management of Patients of the Elderly Age With Benign Prostatic Hyperplasia

Comparative Analysis of Transusrethral Bipolar Resection and Enucleation in Benign Prostatic Hyperplasia in Combination With Cystolithotripsia

Features of compensatory and adaptive reactions of the vascular bed of the bladder of elderly and senile men with prostatic hyperplasia

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