Skip to main content

Advertisement

SpringerLink
Log in

Other therapies for BPH patients: desmopressin, anti-cholinergic, anti-inflammatory drugs, and botulinum toxin

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

The usual treatments of benign prostate hyperplasia (BPH) including the alpha-blockers, the inhibitors of the 5-alpha reductase and the phytotherapy drugs allow significant improvements of the lower urinary tracts symptoms (LUTS). However, some patients are not responders or have side effects due to the treatments. Other therapeutic approaches described in the literature are possible in order to alleviate the LUTS. The anti-cholinergic drugs seem to be efficient against the irritating symptoms even if they are supposed to be contra-indicated when there is BPH. Anti-diuretic hormone could be useful to treat nocturia due to diuresis reversal. Inflammation is a part of the underlying mechanisms of BPH and as such the role of the anti-inflammatory drugs has to be revised. Eventually, botulinum toxin is more and more used for patients with neurological bladder and could also have a role in LUTS. If the coming clinical studies on those different treatments confirm the preliminary results, the learning societies in charge of the guidelines would have to update the decision trees by adding these new therapeutic approaches.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Berry SJ, Coffey DS, Walsh PC, Ewing LL (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479

    PubMed  CAS  Google Scholar 

  2. Girman CJ, Jacobsen SJ, Tsukamoto T, Richard F, Garraway WM, Sagnier PP, Guess HA, Rhodes T, Boyle P, Lieber MM (1998) Health-related quality of life associated with lower urinary tract symptoms in four countries. Urol Mar 51(3):428–436

    Article  CAS  Google Scholar 

  3. Van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose GR, Mattiasson A, Robertson GL, Weiss J (2002) International continence society. The standardization of terminology in nocturia: report from the standardization subcommittee of the International Continence Society. BJU Int 90(Suppl 3):11–15

    Article  PubMed  Google Scholar 

  4. Asplund R, Aberg H (1991) Diurnal variation in the levels of antidiuretic hormone in the elderly. J Intern Med 229(2):131–134

    Article  PubMed  CAS  Google Scholar 

  5. Cugini P, Battisti P, Di Palma L, Cavallini M, Pozzilli P, Scibilia G, Letizia C, Cassisi A, Cioli AR, Marino B (1992) Secondary aldosteronism documented by plasma renin and aldosterone circadian rhythm in subjects with kidney or heart transplantation. Ren Fail 14(1):69–76

    Article  PubMed  CAS  Google Scholar 

  6. Mattiasson A, Abrams P, Van Kerrebroeck P, Walter S, Weiss J (2002) Efficacy of desmopressin in the treatment of nocturia: a double-blind placebo-controlled study in men. BJU Int 89(9):855–862

    Article  PubMed  CAS  Google Scholar 

  7. Lose G, Mattiasson A, Walter S, Lalos O, van Kerrebroeck P, Abrams P, Freeman R (2004) Clinical experiences with desmopressin for long-term treatment of nocturia. J Urol 172(3):1021–1025

    Article  PubMed  CAS  Google Scholar 

  8. Abrams P, Mattiasson A, Lose GR, Robertson GL (2002) The role of desmopressin in the treatment of adult nocturia. BJU Int 90(Suppl 3):32–36

    Article  PubMed  CAS  Google Scholar 

  9. Le Normand (2005) Comment je prescris le Minirin chez l’adulte. Progrès FMC 15(2):2–3

    Google Scholar 

  10. Peters TJ, Donovan JL, Kay HE, Abrams P, de la Rosette JJ, Porru D, Thuroff JW (1997) The International Continence Society “Benign Prostatic Hyperplasia” Study: the botherosomeness of urinary symptoms. J Urol 157(3):885–889

    Article  PubMed  CAS  Google Scholar 

  11. Hyman MJ, Groutz A, Blaivas JG (2001) Detrusor instability in men: correlation of lower urinary tract symptoms with urodynamic findings. J Urol 166(2):550–552

    Article  PubMed  CAS  Google Scholar 

  12. Greenland JE, Brading AF (2001) The effect of bladder outflow obstruction on detrusor blood flow changes during the voiding cycle in conscious pigs. J Urol 165(1):245–248

    Article  PubMed  CAS  Google Scholar 

  13. Harrison SC, Hunnam GR, Farman P, Ferguson DR, Doyle PT (1987) Bladder instability and denervation in patients with bladder outflow obstruction. Br J Urol 60(6):519–522

    Article  PubMed  CAS  Google Scholar 

  14. Mirone V, Imbimbo C, Sessa G, Palmieri A, Longo N, Granata AM, Fusco F (2004) Correlation between detrusor collagen content and urinary symptoms in patients with prostatic obstruction. J Urol 172(4 Pt 1):1386–1389

    Article  PubMed  CAS  Google Scholar 

  15. Seki N, Karim OM, Mostwin JL (1992) Changes in electrical properties of guinea pig smooth muscle membrane by experimental bladder outflow obstruction. Am J Physiol 262(5 Pt 2):F885–F891

    PubMed  CAS  Google Scholar 

  16. Lee JY, Kim HW, Lee SJ, Koh JS, Suh HJ, Chancellor MB (2004) Comparison of doxazosin with or without tolterodine in men with symptomatic bladder outlet obstruction and an overactive bladder. BJU Int 94(6):817–820

    Article  PubMed  CAS  Google Scholar 

  17. Chapple CR (2004) Pharmacological therapy of benign prostatic hyperplasia/lower urinary tract symptoms: an overview for the practising clinician. BJU Int 94(5):738–744

    Article  PubMed  Google Scholar 

  18. Athanasopoulos A, Gyftopoulos K, Giannitsas K, Fisfis J, Perimenis P, Barbalias G (2003) Combination treatment with an alpha-blocker plus an anti-cholinergic for bladder outlet obstruction: a prospective, randomized, controlled study. J Urol 169(6):2253–2256

    Article  PubMed  CAS  Google Scholar 

  19. Kaplan SA, Walmsley K, Te AE (2005) Tolterodine extended release attenuates lower urinary tract symptoms in men with benign prostatic hyperplasia. J Urol 174(6):2273–2275

    Article  PubMed  Google Scholar 

  20. Roehrborn C, Kaplan SA, Noble WD, Lucia MS, Slawin KM, McVary KT, Kusek JW, Nyberg LM (2005) The impact of acute or chronic inflammation in baseline biopsy on the risk of clinical progression of BPH: results from the MTOPS study. J Urol AUA #1277

  21. Araki T, Yokoyama T, Kumon H (2004) Effectiveness of a nonsteroidal anti-inflammatory drug for nocturia on patients with benign prostatic hyperplasia: a prospective non-randomized study of loxoprofen sodium 60 mg once daily before sleeping. Acta Med Okayama 58(1):45–49

    PubMed  CAS  Google Scholar 

  22. Di Silverio F, Bosman C, Salvatori M, Albanesi L, Proietti Pannunzi L, Ciccariello M, Cardi A, Salvatori G, Sciarra A (2005) Combination therapy with rofecoxib and finasteride in the treatment of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Eur Urol 47(1):72–78

    Article  PubMed  CAS  Google Scholar 

  23. Doggweiler R, Zermann DH, Ishigooka M, Schmidt RA (1998) Botox-induced prostatic involution. Prostate 37(1):44–50

    Article  PubMed  CAS  Google Scholar 

  24. Maria G, Destito A, Lacquaniti S, Bentivoglio AR, Brisinda G, Albanese A (1998) Relief by botulinum toxin of voiding dysfunction due to prostatitis. Lancet 352(9128):625

    Article  PubMed  CAS  Google Scholar 

  25. Kuo HC (2003) Botulinum A toxin urethral injection for the treatment of lower urinary tract dysfunction. J Urol 170(5):1908–1912

    Article  PubMed  CAS  Google Scholar 

  26. Maria G, Brisinda G, Civello IM, Bentivoglio AR, Sganga G, Albanese A (2003) Relief by botulinum toxin of voiding dysfunction due to benign prostatic hyperplasia: results of a randomized, placebo-controlled study. Urology 62(2):259–264

    Article  PubMed  Google Scholar 

  27. Kuo HC (2005) Prostate botulinum A toxin injection—an alternative treatment for benign prostatic obstruction in poor surgical candidates. Urology 65(4):670–674

    Article  PubMed  Google Scholar 

  28. Larson TR, Huidobro C, Acevedo C, Mynderse L, Larson B (2005) Intraprostatic Injection of Botulinum Toxin in the treatment of symptomatic LUTS, including sequential MRIs for accurate changes in size of the prostate. J Urol, AUA San Antonio, abstract 1386

  29. Guercini F, Giannantoni A, Bard RL, Brinsida G, Cadeddu F, Maria G, Rosi P, Pajoncini C, Porena M (2005) Inraprostatic botulin toxin injection in patients with severe Benign Prostatic Hyperplasia a multicenter feasibility study. J Urol, AUA San Antonio, abstract 1387

Download references

Author information

Authors and Affiliations

  1. Department of Urology, CHU Mondor, Assistance Publique des Hôpitaux de Paris, 51, avenue du Maréchal de Lattre de Tassigny, 94000, Creteil, France

    Alexandre de la Taille

  2. Department of Urology, CHU, Angers, France

    Abdel-Rahmène Azzouzi

  3. Department of Urology, CHU, Amiens, France

    Marc Fourmarier

  4. Department of Urology, CHU Saint Louis, Paris, France

    Francois Desgrandchamps

  5. Department of Urology, CHRU, Lille, France

    Charles Ballereau

  6. Department of Urology, CHU, Strasbourg, France

    Christian Saussine

  7. Department of Urology, CHU, Tours, France

    Olivier Haillot

  8. Department of Urology, CHU Tenon, Paris, France

    Bertrand Lukacs

  9. Department of Urology, CHU, Lyon, France

    Marian Devonec

Authors
  1. Abdel-Rahmène Azzouzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc Fourmarier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Francois Desgrandchamps
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Charles Ballereau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Saussine
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Olivier Haillot
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bertrand Lukacs
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marian Devonec
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alexandre de la Taille
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexandre de la Taille.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Azzouzi, AR., Fourmarier, M., Desgrandchamps, F. et al. Other therapies for BPH patients: desmopressin, anti-cholinergic, anti-inflammatory drugs, and botulinum toxin. World J Urol 24, 383–388 (2006). https://doi.org/10.1007/s00345-006-0095-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-006-0095-x

Keywords

Search

Navigation