學術論壇
學術論壇可提供瀏覽者及一般會員閱讀瀏覽學術文章。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 王炯珵 | 比較tamsulosin和alfuzosin對於正常男性射精功能的影響 | 2006/11/28 下午 01:27:30 | 0 |
| 原 文 | 題 目 | Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. |
| 作 者 | Hellstrom WJ, Sikka SC. | |
| 出 處 | Journal of Urology | |
| 出版日期 | 2006 Oct;176(4 Pt 1):1529-33. | |
| 評 論 |
在這個世界上，有時候我們經常會自以為是認為某個現象是某個未經證實的原因所引起的，例如比起其他的alpha-blocker，Tamsulosin較容易造成逆行性射精，原因是膀胱頸被Tamsulosin放鬆的結果，如果您也跟我一樣想就錯了。 來自美國New Orleans的研究，使用0.8 mg Tamsulosin daily，10 mg Alfuzosin daily和Placebo在健康男性上的實驗顯示，Tamsulosin比其他二組射精量減少，35% Tamsulosin這組無射精，但其他二組沒有無射精。 最有趣的發現是檢查射精後的尿液，精蟲量並沒有差異，意思是說精液並沒有逆行流回膀胱內。 所以Tamsulosin造成無射精，並非放鬆膀胱頸所致，而是可能由於Tamsulosin作用於儲精囊或輸精管，或是由於在射精機轉中對於serotonergic和dopaminergic receptors的central actions所造成的。 在動物實驗顯示，Tamsulosin對於D3和5-HT1A receptors 有親和力，而Alfuzosin並沒有，這會減少電刺激產生的輸精管的收縮。另外Tamsulosin會通過BBB(blood brain barrier)對central的alpha receptor也會產生作用，這也會對5-HT1A和D2、D3 receptor有作用。 多讀書可以減少我們的偏見和無知，我也要學唐教授講話像個哲學家。 |
|
| abstract |
PURPOSE: The frequency of ejaculatory dysfunction in men varies among the alpha-blockers used in the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia. We assessed the effect of acute administration of tamsulosin, alfuzosin and placebo on ejaculate volume and sperm concentration in post-ejaculate urine, and addressed the mechanism of action of tamsulosin and alfuzosin on ejaculation. MATERIALS AND METHODS: Using a randomized, 3-way crossover design, the effects of 5 days of treatment with 0.8 mg tamsulosin daily, 10 mg alfuzosin daily and placebo on ejaculation in healthy adult men were compared. The primary end points of the study were ejaculate volume and sperm concentration in post-ejaculate urine on each treatment. To aid in clinical interpretation of primary efficacy end points, each primary end point was transformed into a binary outcome, that is subjects with a greater than 20% decrease in ejaculate volume and subjects with a greater than 20% increase in sperm concentration in post-ejaculate urine. RESULTS: In healthy volunteers who completed the study (48), tamsulosin resulted in significantly decreased ejaculate volume (-2.4 +/- 0.17 ml) compared to alfuzosin (+0.3 +/- 0.18 ml, p < 0.0001 vs tamsulosin) or placebo (+0.4 +/- 0.18 ml, p < 0.0001 vs tamsulosin, p = nonsignificant vs alfuzosin). Among completers the incidence of more than 20% decreased ejaculate volume was significantly greater with tamsulosin (89.6%) compared to alfuzosin (20.8%, p < 0.0001 vs tamsulosin) or placebo (12.5%, p < 0.0001 vs tamsulosin, p = nonsignificant vs alfuzosin). While on tamsulosin 35.4% of 48 completers had complete lack of ejaculation (anejaculation) and no subjects experienced anejaculation while on alfuzosin or placebo. CONCLUSIONS: On 0.8 mg tamsulosin daily ejaculatory function in subjects was marked by decreased ejaculate volume in almost 90% of subjects and anejaculation in approximately 35% of participants. These ejaculatory disorders with tamsulosin were not attributed to retrograde ejaculation. In contrast, anejaculation was not observed in any subjects in the alfuzosin or placebo groups. |
|
| 回覆發表 | 回覆討論主題內容 | 最後發表 |
| 目前尚無任何相關的回覆資料 | ||