Mehmet KAYNAR, Serdar GÖKTAŞ, Emre ALTINTAŞ

Benign Prostat Hiperplazisi ve Antimuskarinik Tedavi

Alt üriner sistem semptomları (AÜSS) terimi; üriner sistem semptomlarına sahip erkek hastaları değerlendirmede kullanılan prostatizm, semptomatik benign prostat hiperplazisi (BPH) ve klinik BPH terimlerinin yerini almaktadır. BPH, aşırı aktif mesane (AAM), nokturnal poliüri, üriner sistem enfeksiyonları, distal üreter taşları ve mesane tümörleri gibi birçok sağlık sorunu AÜSS'ye neden olabilir. Yaygın kullanılan bir terim olan AÜSS kapsamına giren semptomlar; depolama (acil idrar yapma hissi, sık idrara çıkma, gece idrar yapmak için uyanma ve urge inkontinans), işeme (işeme gücünde azalma, idrarı başlatmakta gecikme, kesik kesik idrar yapma) ve işeme sonrası (işeme sonrası damlama, yetersiz boşaltım hissi) ile ilgili semptomlar olarak üç alt grupta toplanmıştır. Günümüzde BPH için uygulanan en yaygın ve standart tıbbi tedavide ?1-adrenerjik reseptör antagonistleri kullanılmaktadır. Bu tedavinin yetersiz kaldığı düşünülen durumlar için alternatif tedavi arayışları halen sürmektedir. Bu çalışmalar sonucunda, BPH'nin tedavisinde ?1blokerler ile birlikte kullanılan antimuskarinik ilaçlar, bir kombine tedavi olarak literatürdeki yerini almıştır. Bu derlemede; BPH'den muzdarip hastalarda antimuskarinik tedavilerinin etkinliği ve güvenilirliği değerlendirilmiştir

Benign Prostatic Hyperplasia and Antimuscarinic Treatment

The term lower tract urinary symptoms (LUTS) has been replacing the terms such as prostatism, symptomatic benign prostatic hyperplasia (BPH), and clinical BPH used in the evaluation of male patients with symptoms associated with the urinary system. Many health conditions including BPH, overactive bladder (OAB), nocturnal polyuria, urinary tract infections, distal ureteral calculi, and bladder tumors can cause LUTS. The symptoms covered by the commonly used term LUTS are categorized into three subgroups; those associated with storage, those associated with urination, and those seen after urination. Today the standard and most common medical treatment for BPH is the use ?1- adrenergic receptor blockers. However, the search for alternative treatment modalities continues, especially for situations in which ?1-adrenergic receptor blockers are considered as insufficient. With the relevant reports in the literature, this led to the use of antimuscarinic drugs together with the ?1-adrenergic receptor blockers as a combination therapy to treat BPH. This paper reviews the effectiveness and safety of the use of antimuscarinic treatments in patients with BPH

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