Alpha adrenoceptor antagonists in the year 2000: is there anything new?

Chapple, Christopher R.

doi:10.1097/00042307-200101000-00002

Cited by 33 publications

(21 citation statements)

References 59 publications

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“…5-ARI lowers the serum dihydrotestosterone level and reduces the volume of the prostate [12]. Alpha-adrenergic blockers improve voiding symptoms by relaxation of smooth muscle in the prostate [13]. However, when patients have concomitant complications such as hematuria, infection, or urinary tract obstruction, surgical management is warranted [14].…”

Section: Discussionmentioning

confidence: 99%

Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis

et al. 2013

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PurposeThanks to advancements in surgical techniques and instruments, many surgical modalities have been developed to replace transurethral resection of the prostate (TURP). However, TURP remains the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH). We conducted a meta-analysis on the efficacy and safety of minimally invasive surgical therapies for BPH compared with TURP.MethodsThis meta-analysis used a Medline search assessing the period from 1997 to 2011. A total of 784 randomized controlled trials were identified in an electronic search. Among the 784 articles, 36 randomized controlled trials that provided the highest level of evidence (level 1b) were included in the meta-analysis. We also conducted a quality analysis of selected articles.ResultsOnly 2 articles (5.56%) were assessed as having a low risk of bias by use of the Cochrane collaboration risk of bias tool. On the other hand, by use of the Jadad scale, there were 26 high-quality articles (72.22%). Furthermore, 28 articles (77.78%) were assessed as high-quality articles by use of the van Tulder scale. Holmium laser enucleation of the prostate (HoLEP) showed the highest reduction of the International Prostate Symptom Score compared with TURP (P<0.0001). Bipolar TURP, bipolar transurethral vaporization of the prostate, HoLEP, and open prostatectomy showed superior outcome in postvoid residual urine volume and maximum flow rate. The intraoperative complications of the minimally invasive surgeries had no statistically significant inferior outcomes compared with TURP. Also, there were no statistically significant differences in any of the modalities compared with TURP.ConclusionsThe selection of an appropriate surgical modality for BPH should be assessed by fully understanding each patient's clinical conditions.

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Section: Discussionmentioning

confidence: 99%

Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis

et al. 2013

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“…Furthermore, α1-ARAs are characterized by a rapid onset to action, a high urine flow rate, and a significant improvement in patients’ symptom scores. In addition, α1-ARAs show a good profile of safety, thus representing a valuable choice of first-line treatment in patients with moderate to severe LUTS [92,93,94,95]. …”

Section: α1-blockersmentioning

confidence: 99%

Apoptotic Pathways Linked to Endocrine System as Potential Therapeutic Targets for Benign Prostatic Hyperplasia

Minutoli

Rinaldi

Marini

et al. 2016

IJMS

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Benign prostatic hyperplasia (BPH) is a chronic condition common in older men that can result in bothersome lower urinary tract symptoms. The molecular mechanisms and networks underlying the development and the progression of the disease are still far from being fully understood. BPH results from smooth muscle cell and epithelial cell proliferation, primarily within the transition zone of the prostate. Apoptosis and inflammation play important roles in the control of cell growth and in the maintenance of tissue homeostasis. Disturbances in molecular mechanisms of apoptosis machinery have been linked to BPH. Increased levels of the glycoprotein Dickkopf-related protein 3 in BPH cause an inhibition of the apoptosis machinery through a reduction in B cell lymphoma (Bcl)-2 associated X protein (Bax) expression. Inhibitors of apoptosis proteins influence cell death by direct inhibition of caspases and modulation of the transcription factor nuclear factor-κB. Current pharmacotherapy targets either the static component of BPH, including finasteride and dutasteride, or the dynamic component of BPH, including α-adrenoceptor antagonists such as tamsulosin and alfuzosin. Both these classes of drugs significantly interfere with the apoptosis machinery. Furthermore, phytotherapic supplements and new drugs may also modulate several molecular steps of apoptosis.

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“…[19][20][21][22][23][24][25][26][27] (Level 1 Evidence, Grade A Recommendation). Alfuzosin, doxazosin, tamsulosin and terazosin are appropriate treatment options for LUTS secondary to BPH.…”

Section: Alpha-blockersmentioning

confidence: 99%