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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 周永強 | Vardenafil能改善男性脊椎受傷患者的尿路動力學因素 | 2007/10/25 下午 01:13:43 | 1 |
| 原 文 | 題 目 | Vardenafil Improves Urodynamic Parameters in Men With Spinal Cord Injury: Results From a Single Dose, Pilot Study |
| 作 者 | Mauro Gacci,* Giulio Del Popolo, Angelo Macchiarella, Maria Celso, Gianni Vittori,Alberto Lapini, Sergio Serni, Peter Sandner, Mario Maggi† and Marco Carini | |
| 出 處 | Journal of Urology Vol. 178, 2040-2044 | |
| 出版日期 | November 2007 | |
| 評 論 | 因為在老鼠的下尿路系統組織中發現PDE5的含量比在corpora cavernosa中的含量多, 加上在人類的膀胱中發現PDE5的基因和蛋白, 因此最近有許多研究針對PDE5的拮抗劑使用於改善下泌尿道症狀的結果有初步發現. 這篇文章發表於今年11月的J Urol,主要是將Vardenafil 20mg給予因為脊椎受傷而有排尿問題和陽痿的病人. 這些病人已經有服用oxybutynin. 結果發現有服用Vardenafil的病人在尿路動力學檢查中發現對於最高逼尿肌壓力有顯著性下降, 並增加maximum cystometric capacity和逼尿肌過度活動容量. 這個結果使我們發現PDE5的抑制劑對於膀胱有明顯的作用. 而PDE5的抑制劑對於膀胱作用正確的機轉有待未來更多的研究來尋找. | |
| abstract |
Purpose: We assessed urodynamic changes after vardenafil administration in spinal cord injured male patients on oxybutynin treatment. Materials and Methods: We performed a single center, randomized, double-blind, placebo controlled trial in 25 patients with spinal cord injury who had erectile dysfunction and micturition disorders. A baseline urodynamic test was performed as well as a second urodynamic test 1 to 3 hours after the administration of 20 mg vardenafil and placebo in 15 and 10 cases, respectively. In all patients standard oral oxybutynin administration was not discontinued. Statistical assessment included the 3 urodynamic parameters maximum detrusor pressure during voiding, maximum cystometric capacity and detrusor overactivity volume. Results: Placebo administration did not affect urodynamic parameters. After vardenafil administration maximum detrusor pressure was significantly decreased (59.3 vs 52.1 cm H2O, p < 0.001) and maximum cystometric capacity considerably improved (233.5 vs 272 ml, p < 0.001). The most dramatic variations were observed for detrusor overactivity volume (174 vs 218 ml, p < 0.0001). In 7 patients with American Spinal Injury Association classification A and spinal cord injury above T6 we observed the most significant improvement in the evaluated urodynamic items, including maximum detrusor pressure 57 vs 52 cm H2O (p = 0.039), maximum cystometric capacity 253 vs 296 ml (p = 0.004) and detrusor overactivity volume 177 vs 229 ml (p = 0.003). Conclusions: This trial demonstrates that in spinal cord injured patients a single 20 mg vardenafil administration achieved a significant decrease in maximum detrusor pressure, an improvement in maximum cystometric capacity and a remarkable increase in detrusor overactivity volume value. Key Words: bladder; spinal cord injuries; impotence; vardenafil; cyclic nucleotide phosphodiesterases, type 5 |
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| 王炯珵 |
It is an intriguing study. The clinical application of PDE5 inhibitor has been expanded in recent years. It seems a good alternative to treat BPH, voiding dysfunction and others associated conditions. However, this study showed the max detrusor pressure decreased from 59 to 52cmH2O. Although the p-value is less than 0.05, I think the clinical benefit is very small. | 2007/12/8 下午 04:46:10 |