Abstract
Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. Patients with BPH often present with a combination of obstructive and overactive bladder (OAB) symptoms. It is postulated that bladder outlet obstruction (BOO) from BPH results in concomitant OAB symptoms through ischemic induced variations in the response to neurotransmitters of both the detrusor and the urothelium. This altered response leads to the pathologic activation of the micturition reflex, generating sensory dysfunction and involuntary bladder contractions. Alpha-1 adrenoceptor antagonists (alpha-blockers) and 5-alpha reductase inhibitors (5-ARIs) are commonly used to treat the BOO caused by BPH. Anticholinergic agents are frequently used to treat concurrently OAB symptoms caused by the BOO. Unfortunately, anticholinergic medications demonstrate bothersome side effects and a theoretical risk of urinary retention. Basic science and clinical research has led to the development of a new class of pharmaceuticals for the treatment of overactive bladder with diminished risk of urinary retention and lacking many anticholinergic side effects. This novel compound, mirabegron (Mybertriq, Astellas Pharma US, Inc.), is a β3-adrenoceptor agonist and represents a promising new class of oral agents designed for the treatment of OAB symptoms, with minimal effect on voiding.
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Conflict of Interest
Dr. Oscar Suarez reported no potential conflicts of interest relevant to this article.
Dr. David Osborn reported no potential conflicts of interest relevant to this article.
Dr. Melissa Kaufman reported consultancies for Astellas, Allergan, and Cook Myosite and payment for development of educational presentations including service on speakers’ bureaus from Astellas and Allergan.
Dr. W. Stuart Reynolds reported no potential conflicts of interest relevant to this article.
Dr. Roger Dmochowski reported consultancies for Medtronic and Allergan.
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Suarez, O., Osborn, D., Kaufman, M. et al. Mirabegron for Male Lower Urinary Tract Symptoms. Curr Urol Rep 14, 580–584 (2013). https://doi.org/10.1007/s11934-013-0363-4
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DOI: https://doi.org/10.1007/s11934-013-0363-4