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01-04-2011 | OPSLAG-LUTS BIJ MANNEN: FOCUS OP DIAGNOSE EN BEHANDELING

Opslag-LUTS bij mannen: focus op diagnose en behandeling

Auteur: dr. J.P.F.A. Heesakkers

Gepubliceerd in: Tijdschrift voor Urologie | Uitgave 2/2011

Samenvatting

De klachten van mannen met lower urinary tract dysfunction (LUTS) zijn net zo vaak gerelateerd aan de opslagfase als aan de mictiefase. Opslag-LUTS bestaat uit klachten van een overactieve blaas (OAB), die al dan niet gepaard gaan met blaasuitgangsobstructie. Vaak blijft de OAB bestaan na een interventie die is gericht op de prostaat. Vanwege de complexe samenhang tussen een OAB en prostaatvergroting is het nodig om de klachten zorgvuldig te analyseren om op grond daarvan een goede behandeling in te stellen. Er bestaat vaak angst voor het optreden van een acute urineretentie bij het voorschrijven van anticholinergica (met of zonder alfablokker), bij mannen met LUTS. Enkele goed uitgevoerde studies laten zien dat acute urineretentie niet vaak voorkomt en dat anticholinergica in de meeste gevallen veilig kunnen worden voorgeschreven, wat leidt tot een beter behandelingsresultaat.

Storage-LUTS; focus on diagnosis and treatment

Male LUTS often is storage LUTS and therefore causes overactive bladder (OAB) complaints. They may occur with or without bladder outlet obstruction, and are often found persistent after interventions targeted to the prostate. Because of the complex interplay between OAB and prostatic enlargement in male LUTS, it is necessary to have a tailored evaluation and treatment regarding this interaction. In spite of concern about possible development of acute urinary retention while using antimuscarinics, the first results of welldesigned studies reveal that these agents (with or without an alpha-blocker) do not adversely affect urinary function and can be safely administered in men with LUTS.

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Irwin DE, Milsom I, Hunskaar S, et al. Population-based survey of urinaryincontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006 Dec;50(6):1306–14.

Abrams P, Cardozo L, Fall M, et al. Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167–78.PubMedCrossRef

Abrams P. Describing bladder storage function: overactive bladder syndrome and detrusor overactivity. Urology. 2003 Nov;62(5 Suppl 2):28–37.

Mostwin JL, Karim OM, van Koeveringe G, Brooks EL. The guinea pig as a model of gradual urethral obstruction. J Urol. 1991 Apr;145(4):854–8.

Steers WD. Pathophysiology of overactive bladder and urge urinary incontinence. Rev Urol. 2002;4 Suppl 4:S7–S18.PubMed

Laniado ME, Ockrim JL, Marronaro A, et al. Serum prostatespecific antigen to predict the presence of bladder outlet obstructionin men with urinary symptoms. BJU Int. 2004 Dec;94(9):1283–6.

Fusco F, Groutz A, Blaivas JG, et al. Videourodynamic studies in men with lower urinary tract symptoms: a comparison of community based versus referral urological practices. J Urol. 2001 Sep;166(3):910–3.

Lee JY, Kim HW, Lee SJ, et al. Comparison of doxazosin with or without tolterodine in men with symptomatic bladder outlet obstruction and an overactive bladder. BJU Int. 2004 Oct;94(6):817–20.

de Groat WC. A neurologic basis for the overactive bladder. Urology. 1997;50(6A Suppl):36–52.PubMedCrossRef

10.

Ziada A, Rosenblum M, Crawford ED. Benign prostatic hyperplasia: an overview. Urology. 1999 ;53(3 Suppl 3a):1–6.PubMedCrossRef

11.

Dmochowski RR, Staskin D. Overactive bladder in men: special considerations for evaluation and management. Urology. 2002;60(5 Suppl 1):56–62.PubMedCrossRef

12.

Thomas AW, Cannon A, Bartlett E, et al. The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic followup of transurethral resection of prostate for bladder outlet obstruction. J Urol. 2005 Nov;174(5):1887–91.

13.

Chapple CR, Roehrborn CG. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol. 2006 Apr;49(4):651–8.

14.

Dawson C, Whitfield H. ABC of urology. Bladder outflow obstruction. BMJ. 1996 Mar 23;312(7033):767–70.

15.

Jacobsen SJ, Girman CJ, Guess HA, et al. Natural history of prostatism: longitudinal changes in voiding symptoms in community dwelling men. J Urol. 1996 Feb;155(2):595–600.

16.

Jacobsen SJ, Jacobson DJ, Girman CJ, et al. Natural history of prostatism: risk factors for acute urinary retention. J Urol. 1997 Aug;158(2):481–7.

17.

Verhamme KM, Dieleman JP, Wijk MA van, et al. Low incidence of acute urinary retention in the general male population: the triumph project. Eur Urol. 2005 Apr;47(4):494–8.

18.

Roehrborn CG, McConnell JD, Saltzman B, et al.; PLESS Study Group. Proscar Long-term Efficacy and Safety Study. Storage (irritative) and voiding (obstructive) symptoms as predictors of benign prostatic hyperplasia progression and related outcomes. Eur Urol. 2002 Jul;42(1):1–6.

19.

Roehrborn CG, Malice M, Cook TJ, Girman CJ. Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials. Urology. 2001 Aug;58(2):210–6.

20.

McConnell JD, Bruskewitz R, Walsh P, et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group. N Engl J Med. 1998 Feb 26;338(9):557–63.

21.

Nickel JC. Placebo therapy of benign prostatic hyperplasia: a 25-month study. Canadian PROSPECT Study Group. Br J Urol. 1998 Mar;81(3):383–7.

22.

Nickel JC, Fradet Y, Boake RC, et al. Efficacy and safety of finasteride therapy for benign prostatic hyperplasia: results of a 2-year randomized controlled trial (the PROSPECT study). Proscar Safety Plus Efficacy Canadian Two year Study. CMAJ. 1996 Nov 1;155(9):1251–9.

23.

Marberger MJ. Long-term effects of finasteride in patients with benign prostatic hyperplasia: a double-blind, placebo-controlled, multicenter study. PROWESS Study Group. Urology. 1998 May;51(5):677–86.

24.

Debruyne F, Barkin J, van Erps P, et al.; ARIA3001, ARIA3002 and ARIB3003 Study Investigators. Efficacy and safety of long-term treatment with the dual 5 alpha-reductase inhibitor dutasteride in men with symptomatic benign prostatic hyperplasia. Eur Urol. 2004 Oct;46(4):488–94.

25.

Roehrborn CG, Bruskewitz R, Nickel GC, et al. Urinary retention in patients with BPH treated with finasteride or placebo over 4 years. Characterization of patients and ultimate outcomes. The PLESS Study Group. Eur Urol. 2000 May;37(5):528–36.

26.

McConnell JD, Roehrborn CG, Bautista OM, et al.; Medical Therapy of Prostatic Symptoms (MTOPS) Research Group. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003 Dec 18;349(25):2387–98.

27.

Roehrborn CG, Abrams P, Rovner ES, et al. Efficacy and tolerability of tolterodine extended-release in men with overactive bladder and urgency urinary incontinence. BJU Int. 2006 May;97(5):1003–6.

28.

Emberton M. Definition of at-risk patients: dynamic variables. BJU Int. 2006;97 Suppl 2:12–5.PubMedCrossRef

29.

Andersson KE, Yoshida M. Antimuscarinics and the overactive detrusor – which is the main mechanism of action? Eur Urol. 2003 Jan;43(1):1–5.

30.

Reynard JM. Does anticholinergic medication have a role for men with lower urinary tract symptoms/benign prostatic hyperplasia either alone or in combination with other agents? Curr Opin Urol. 2004 Jan;14(1):13–6.

31.

Abrams P, Kaplan S, Koning Gans HJ de, Millard R. Safety and tolerability of tolterodine for the treatment of overactive bladder in men with bladder outlet obstruction. J Urol. 2006 Mar;175(3 Pt 1): 999–1004.

32.

Roehrborn CG, Abrams P, Rovner ES, et al. Efficacy and tolerability of tolterodine extended-release in men with overactive bladder and urgency urinary incontinence. BJU Int. 2006 May;97(5):1003–6.

33.

Abrams P, Kaplan S, De Koning Gans HJ, Millard R. Safety and tolerability of tolterodine for the treatment of overactive bladder in men with bladder outlet obstruction. J Urol. 2006 Mar;175(3 Pt 1): 999–1004.

34.

Elinoff V, Bavendam T, Glasser DB, et al. Symptom-specific efficacy of tolterodine extended release in patients with overactive bladder: the IMPACT trial. Int J Clin Pract. 2006 Jun;60(6):745–51.

35.

Ronchi P, Gravina GL, Galatioto GP, et al. Urodynamic parameters after solifenacin treatment in men with overactive bladder symptoms and detrusor underactivity. Neurourol Urodyn. 2009;28(1):52–7.PubMedCrossRef

36.

Kaplan SA, Roehrborn CG, Rovner ES, et al. Tolterodine and tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder: a randomized controlled trial. JAMA. 2006 Nov 15;296(19):2319-28. Erratum in: JAMA. 2007 Oct 24;298(16):1864. JAMA. 2007 Mar 21:297(11):1195.

Titel: Opslag-LUTS bij mannen: focus op diagnose en behandeling
Auteur: dr. J.P.F.A. Heesakkers
Publicatiedatum: 01-04-2011
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Tijdschrift voor Urologie / Uitgave 2/2011
Print ISSN: 2211-3037
Elektronisch ISSN: 2211-4718
DOI: https://doi.org/10.1007/s13629-011-0009-6

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