Alpha-Blockade in the Treatment of Symptomatic Benign Prostatic Hyperplasia

Eri, Lars M.; Tveter, Kjell J.

doi:10.1016/s0022-5347(01)66936-2

Cited by 76 publications

(9 citation statements)

References 82 publications

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“…The mean improvement in total symptom score is estimated < 39% for patients receiving a 1 -AR antagonists and < 25% for those receiving placebo, i.e. a difference of < 14% [16]. Patients receiving a 1 -AR antagonists perceived the reduction in symptom score as a`moderate' level of improvement.…”

Section: Pathophysiology Of Lutsmentioning

confidence: 99%

Current view and status of the treatment of lower urinary tract symptoms and neurogenic lower urinary tract dysfunction

Κakizaki

Koyanagi

2000

BJU International

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Section: Pathophysiology Of Lutsmentioning

confidence: 99%

Current view and status of the treatment of lower urinary tract symptoms and neurogenic lower urinary tract dysfunction

Κakizaki

Koyanagi

2000

BJU International

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“…1-adrenoceptor (AR) antagonists, 5alpha-reductase inhibitors and phytotherapy seem to be useful for improvement of the current therapy. 1-adrenoceptor antagonists relieve symptoms by relaxing prostatic smooth muscle by blocking stimulation of postjunctional 1 -adrenoceptors [88,89]. Previous studies on human prostate suggest that the response to electrical field stimulation is almost completely suppressed by -adrenoceptor antagonists [90][91][92].…”

Section: P2 Receptors In Prostatementioning

confidence: 99%

Purinergic (P2) Receptor Control of Lower Genitourinary Tract Function and New Avenues for Drug Action: An Overview

Gür

Kadowitz²

2007

CPD

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Micturition, penile erection, contraction of prostatic smooth muscle, peristalsis of the male excurrent duct system and lumbosacral spinal cord neurotransmission all require adenosine 5'-triphosphate (ATP) activity and this likely involves purinergic (P2) receptors. P2 receptors are categorized as either ligand-gated ionotropic P2X or metabotropic G-protein-coupled P2Y subtypes. In the urinary bladder, purinergic receptor mechanisms are involved in both motor and sensory function. In the prostate, P2X1-receptors, which mediate contraction, are present in the fibromuscular stroma while G protein-coupled P2Y purinoceptors have a wide range of actions in prostate cancer. In the excretory ducts of the testis (ductus epididymidis, vas deferens and its associated seminal vesicles), heavy immunostaining for P2X1 and P2X2 subtypes is detected in the membranes of smooth muscle, suggesting their role in sperm transport and ejaculation. In the penis, intense P2X1 and weak P2X2 immunoreactivity are observed in smooth muscle of blood vessels and the corpus cavernosum, implying their participation in detumescence. Human corporal cavernosum stimulation induces relaxation of P2Y purinoceptors. Targeting of extracellular or intracellular P2X and/or P2Y receptor signaling pathways holds promise in affecting the lower genitourinary tract system. Our advancing knowledge about purine agonists and their pharmacologic benefits in erectile, ejaculatory, urinary bladder and prostatic hyperplasia may service clinical problems in the near future.

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“…Furthermore, by radioligand binding, it has been shown that that main subtype of α 1 -adrenoceptor is α 1Α (Wada et al 1996). It has been suggested that part of the beneficial effects of α 1 -adrenoceptor antagonists in patients with benign prostatic hyperplasia (Eri and Tveter 1995), is exerted at spinal/supraspinal sites (Andersson, 1995). Since indoramin has selectivity for the α 1A -adrenoceptor subtype (Forray et al 1994), whereas most clinically used α 1 -adrenoceptor antagonists, including doxazosin, have no subtype selectivity (Forray et al 1994), indoramin was chosen for investigation.…”

Section: Effect Of Intravesically Infused Capsaicinmentioning

confidence: 99%

“…Indoramin and other α 1 -adrenoceptor antagonists have been successfully used for alleviation of symptoms in patients with benign prostatic hyperplasia (Eri and Tveter 1995), and it has been suggested that part of their effects is exerted at spinal/supraspinal sites (Andersson 1995). Indoramin has selectivity for the α 1A -adrenoceptor subtype, whereas most clinically used α 1 -adrenoceptor antagonists, including doxazosin, have no subtype selectivity (Forray et al 1994).…”

Section: Introductionmentioning

confidence: 99%

Stimulation of bladder activity by volume, L-dopa and capsaicin in normal conscious rats - effects of spinal α1-adrenoceptor blockade

Ishizuka

Pandita

Mattiasson

et al. 1997

Naunyn-Schmiedeberg's Arch Pharmacol

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To study possible differences in alpha 1-adrenoceptor involvement in the spinal mechanisms mediating bladder activity induced by volume (bladder filling), central (L-dopa), and peripheral (capsaicin) stimulation, we investigated if these types of bladder activity were modified by intrathecal (i.t.) or intra-arterial (i.a.) administration of the alpha 1-adrenoceptor antagonist, indoramin. Indoramin is selective for the alpha 1A-adrenoceptor subtype, whereas most clinically used alpha 1-adrenoceptor antagonists, including doxazosin, have no subtype selectivity. The drug effects were studied by continuous cystometry in normal, conscious rats and rats with bladder activity evoked by intraperitoneal L-dopa (50 mg/kg after carbidopa pretreatment), or by intravesical capsaicin (30 microM). I.t. indoramin (50 nmol) significantly decreased micturition pressure, and increased bladder capacity and micturition volume. Dribbling incontinence due to urinary retention was observed in one of ten rats. L-dopa-stimulated bladder overactivity was significantly attenuated by i.t. or i.a. indoramin (50 nmol). Similar effects of i.t. and i.a. doxazosin (50 nmol) have been reported previously. Intravesical capsaicin (30 microM) caused bladder activity, which was attenuated by i.t. indoramin (50 nmol), but not by i.t. doxazosin (50 nmol). I.a. indoramin did not reduce capsaicin-induced bladder activity; doxazosin was moderately effective. The results suggest that the bulbospinal micturition reflex evoked by bladder filling and L-dopa involves a descending pathway where transmission is partly mediated by spinal alpha 1-adrenoceptors. Bladder overactivity evoked by intravesical capsaicin, which elicits a vesicospinal-vesical reflex, was not affected by i.t. doxazosin in a dose that attenuates activity mediated through the bulbo-spinal pathway. This suggests less involvement of spinal alpha 1-adrenoceptors in the vesico-spinal-vesical than in the bulbo-spinal voiding reflex.

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Alpha-Blockade in the Treatment of Symptomatic Benign Prostatic Hyperplasia

Cited by 76 publications

References 82 publications

Current view and status of the treatment of lower urinary tract symptoms and neurogenic lower urinary tract dysfunction

Current view and status of the treatment of lower urinary tract symptoms and neurogenic lower urinary tract dysfunction

Purinergic (P2) Receptor Control of Lower Genitourinary Tract Function and New Avenues for Drug Action: An Overview

Stimulation of bladder activity by volume, L-dopa and capsaicin in normal conscious rats - effects of spinal α1-adrenoceptor blockade

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