Comparative assessment of combined therapy of neurogenic hyperactivity of detrusor in patients with Parkinson's disease

We studied clinical characteristics of voiding disorders to improve treatment results in patients with Parkinson's disease (PD) in 64 PD patients (28 women and 36 men aged 45 to 76 years, mean age 62.5 +/- 9.4 years). Duration of PD was 8.0 +/- 3.4 years, history of voiding disorders--2.1 +/- 0.8 years. Hyperactive urinary bladder was the cause of voiding disorders in all the patients. The examinees have undergone physical examination, microscopic and cultural examination of the urine, ultrasound investigation of the kidneys, urinary bladder and prostate with determination of residual urine, urodynamic examination of the lower urinary tracts. All the patients were divided into four groups. Group 1 of 10 patients received antiparkinsonian therapy which corrected voiding disorders. Group 2 (n = 26) received tolterodin in a dose 4 mg/day, group 3 (n = 14) received oxibutinin in a dose 5 mg/day, group 4 (n = 14) were treated with trospium chloride in a dose 30 mg/day. Thus, initial correction of antiparkinsonian therapy was made in 64 patients, after this correction voiding disorders reduced in 10 patients and no further treatment was needed. Voiding disorders reduced in all 3 groups of patients given the drugs. Cystometric capacity of the bladder increased in all 4 groups from 155 (86-450) ml to 220 (105-530) ml, on the average, and unstable contractions of the urinary bladder decreased from 3.1 (1-8) to 1.6 (0-5). Quality of life in the examinees improved considerably. The data obtained evidence for M-cholino-blockers efficacy in PD patients with unstable detrusor after correction of antiparkinsonean therapy. Two-month course of tolterodin, oxibutinin and trospium chloride significantly reduced symptoms of urination disorders.     

Comparative evaluation of the effectiveness and safety of combined drug therapy of patients with benign prostatic hyperplasia with finasteride and alfuzozine

A finasteride + alfuzozine combination was used in 3-year treatment of 138 patients with initial benign prostatic hyperplasia (BPH). The principle of the combination is in parallel administration of 5 alpha-reductase inhibitors which inhibit cell proliferation at the hormonal level and alpha-adrenoblockers affecting the smooth muscle component of prostatic stroma and detruzor blood supply. Patients participating in the study had enlanged prostate (at least 60 cm3) and pronounced symptoms (IPSS over 13 scores). Patients of two control groups received alfuzozine and finasteride monotherapy, respectively. Better micturition and relief of BPH symptoms were seen in 96% patients of the study group, 84 and 74% controls, respectively. Thus, compared to monotherapy, finasteride and alfuzozine were more effective in combination which is pathogenetically valid and perspective in BPH chemotherapy.     

Effectiveness of various alfuzosin schedules in patients with benign prostatic hyperplasia (BPH)

238 patients with initial BPH (mean age 64.07 years) were treated with alfusosine in a standard dose 5 mg twice a day for 6 months. After that 117 patients continued the above scheme while 121 patients continued to receive alfusosine in the same dose each other day. The results assessed by IPSS, QOL, maximal urine flow rate, levels of prostate-specific antigen in the serum appeared identical in both groups. Thus, the split course of alfusosine after 6-month standard therapy is perspective as it is more cost effective than the standard scheme being equally beneficial.     

A system of comprehensive assessment of symptoms in chronic prostatitis (CAS-XII)

The system proposed for overall assessment of symptoms in chronic prostatitis was applied in the assessment of 75 patients. The system facilitates detection and analysis of the complaints, quantitates the disease symptoms, provides overall objective characteristics of all the multiplicity of clinical manifestations of chronic prostatitis in each patient by means of digital order. The system is rather effective for dynamic control of the patients' condition and treatment efficacy.     

Efficacy and safety of revocarin in patients with impaired micturition due to prostatic adenoma. An open non-comparative study: results of a multicenter trial

Patients with impaired micturition caused by prostatic adenoma received revocarin for 12-weeks. After the treatment all the patients showed relief of clinical symptoms proved by subjective assessment of urination quality (IPSS and QoL) and objective data (uroflowmetry, ultrasonography). Allergic reactions or other serious side effects were not registered. Thus, a 12-week course of revocarin demonstrated good clinical efficacy and safety in patients with urination problems because of prostatic adenoma. Revocarin can be recommended as an alternative to an original drug omnik.