Most Recent Findings of Curative Drugs for Lower Urinary Tract Symptoms in Clinical Practice

    January 2019 in “ Nihon Yakuri Gakkai nenkai yoshishu ”
    Yoshihisa Matsukawa, Yasuhisa Funabashi, M Gotou
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    TLDR Current treatments for lower urinary tract symptoms include α1-blockers, 5ARIs, PDE5 inhibitors, anticholinergic agents, and β3-adrenergic receptor agonists.
    Current guidelines for treating benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) recommended α1-adrenoceptor antagonists (α1-blockers) like tamsulosin and silodosin, 5-alpha-reductase inhibitors (5ARIs) such as dutasteride and finasteride, and phosphodiesterase 5 (PDE5) inhibitors like tadalafil. α1-blockers worked by relaxing the smooth muscle tone of the prostate and bladder neck, while 5ARIs reduced prostate size by inhibiting 5-AR. Tadalafil, the only PDE5 inhibitor approved for LUTS/BPH, improved symptoms by enhancing nitric oxide/cGMP pathway activity, leading to smooth muscle relaxation. For patients with overactive bladder symptoms, anticholinergic agents or β3-adrenergic receptor agonists were also recommended.
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