Influece of different pharmacotherapy modes on prostate and residual urrine volume in men with LUTS/BPH depending on their androgenic status

A comparative analysis of the influence on the volume of the prostate and the amount of residual urine of different modes of pharmacotherapy (monotherapy, α-1 blocker, 5-α-reductase inhibitor, plant agent, and combination therapy «α-1-blocker + 5-α-reductase inhibitor» together with additional androgen replacement therapy (ART) with testosterone undecanoate and without ART) in men with LUTS/BPH depending on their androgenic status. In routine practice nonregisrering androgen status of patients the most pronounced reduction in prostate volume by 26.6% within the 24 - month therapy was achieved in the group receiving monotherapy of 5-α-reductase inhibitor. Against the background of α-1-blockers monotherapy within 24 months the growth occurred in the mean prostate volume by 8.2% and in monotherapy with a plant agent - 1.1%, respectively. The average volume of residual urine decreased by 35.4%against the background of α-1-blocker monotherapy within 24 months and in 5-α-reductase inhibitor monotherapy - by 56.2%, in plant agent monotherapy - by 8.6% respectively. In the presence of age-related androgen deficiency the standard combination therapy results in hypogonadal men with LUTS/BPH were worse than in the total sample of patients without regard to their androgen status. Combination therapy with using testosterone undecanoate in hypogonadal men with LUTS / BPH had significantly more pronounced, rapid and sustained positive effect on such parameters as the volume of the prostate and the residual urine as compared with the standard combination therapy without androgen status of patients. The additional positive impact of ART on the dynamics of prostate volume and residual urine can significantly reduce the appearance of bladder outlet obstruction.

симптомы нижних мочевых путей (СНМП), аденома предстательной железы (АПЖ), возрастной андрогенный дефицит (гипогонадизм) (ВАД), фармакотерапия, тестостерона ундеканоат, объем предстательной железы, остаточная моча, lower urinary tract symptoms (LUTS), benign prostatic hyperplasia (BPH), late-onset androgen deficiency (hypogonadism) (LOH), pharmacotherapy, testosterone undecanoate, prostate volume, residual urine

1. Братчиков О.И., Тюзиков И.А., Шумакова Е.А., Гресь А.А., Чураев С.А., Михайлов Д.В. Клинико-эпидемиологические корреляции возрастного андрогенного дефицита и СНМП/АПЖ у мужчин // Курский научно-практический вестник «Человек и его здоровье» - 2014. - № 4. - С. 40-45.

2. Братчиков О.И., Шумакова Е.А., Хмарук А.П., Михайлов Д.В. Оптимизация методов медикаментозного лечения больных аденомой предстательной железы // Курский научно-практический вестник «Человек и его здоровье». - 2011. - № 3. - С. 34-41.

3. Попков В.М., Братчиков О.И., Блюмберг Б.И. Клинико-диагностическое значение маркеров клеточного обновления и эндокринных клеток при заболеваниях предстательной железы // Тихоокеанский мед. журнал. - 2011. - № 1. - С. 29-33.

4. Cooper L.A., Page S.T. Androgens and prostate disease // Asian J Androl. - 2014. - Vol. 16, N 2. - P. 248-255.

5. Haider A., Gooren L.J., Padungtod P., Saad F. Concurrent improvement of the metabolic syndrome and lower urinary tract symptoms upon normalisation of plasma testosterone levels in hypogonadal elderly men // Andrologia. - 2009. - Vol. 41. - P. 7-13.

6. Jarvis T.R., Chughtai B., Kaplan S.A. Testosterone and benign prostatic hyperplasia // Asian J Androl. - 2015. - Vol. 17, N 2. - P. 212-216. doi: 10.4103/1008-682X.140966.

7. Karazindiyanoğlu S., Cayan S. The effect of testosterone therapy on lower urinary tract symptoms/bladder and sexual functions in men with symptomatic late-onset hypogonadism // Aging Male. - 2008. - Vol. 11, N 3. - P. 146-149.

8. Ko Y.H., Moon du G., Moon K.H. Testosterone replacement alone for testosterone deficiency syndrome improves moderate lower urinary tract symptoms: one year follow-up // World J Mens Health. - 2013. - Vol. 31, N 1. - P. 47-52.

9. Lee J.H., Kim Y., Park Y.W., Lee D.G. Relationship between benign prostatic hyperplasia/lower urinary tract symptoms and total serum testosterone level in healthy middle-aged eugonadal men // J Sex Med. - 2014. - Vol. 11, N 5. - P. 1309-1315.

10. Oelke M., Bachmann A., Descazeaud A., Emberton M., Gravas S., Michel M.C, N’Dow J., Nordling J., de la Rosette J.J. Guideline on Management of Male Low Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO) // European Association of Urology. - 2013. - 74 p.

11. Pearl J.A., Berhanu D., François N., Masson P., Zargaroff S., Cashy J., McVary K.T. Testosterone supplementation does not worsen lower urinary tract symptoms // J Urol. - 2013. - Vol. 190, N 5. - P. 1828-1833.

12. Shigehara K., Sugimoto K., Konaka H., Iijima M., Fukushima M., Maeda Y., Mizokami A., Koh E., Origasa H., Iwamoto T., Namiki M. Androgen replacement therapy contributes to improving lower urinary tract symptoms in patients with hypogonadism and benign prostate hypertrophy: a randomised controlled study // Aging Male. - 2011. - Vol. 14, N 1. - P. 53-58.

13. Vignozzi L., Rastrelli G., Corona G., Gacci M., Forti G., Maggi M. Benign prostatic hyperplasia: a new metabolic disease? // J Endocrinol Invest. - 2014. - Vol. 37, N 4. - P. 313-322.