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Blasenspeicher- und Entleerungsstörungen

Nebenwirkungen der medikamentösen Therapie

Bladder storage and voiding dysfunctions

Side effects of drug therapy

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Zusammenfassung

Störungen der Blasenspeicher- und Blasenentleerungsfunktion betreffen besonders Patienten beiderlei Geschlechts ab dem 60. Lebensjahr. Der demographische Wandel und die Zunahme der Prävalenz in den höheren Lebensdekaden unterstreichen die klinische Relevanz dieser Erkrankungen. Da neben Verhaltensänderungen primär die medikamentöse Therapie zur Behandlung dieser Erkrankungen eingesetzt wird, ist eine fundierte Kenntnis der zu erwartenden Nebenwirkungen – gerade vor dem Hintergrund der Polypharmazie im Alter – essentiell. Im Folgenden geben wir einen Überblick über die gängigsten Therapeutika mit ihrem Nebenwirkungsspektrum.

Abstract

Bladder storage and voiding dysfunctions primarily affect patients aged 60 and upwards. Demographic changes and an age-related rise in prevalence underline the clinical relevance of these disorders. Besides behavior modification, the primary therapeutic approach is drug therapy. Therefore, a profound knowledge of the potential side effects is essential, particularly regarding the ever rising multidrug administration in the elderly. In this article, we provide a review concerning the potential adverse effects of the most popular therapeutic agents for bladder storage and voiding symptoms.

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Literatur

  1. Taylor BC, Wilt TJ, Fink HA et al (2006) Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology 68:804

    Article  PubMed  Google Scholar 

  2. Gorina Y, Schappert S, Bercovitz A et al (2014) Prevalence of incontinence among older americans. Vital Health Stat 3:1

    Google Scholar 

  3. Parsons JK, Bergstrom J, Silberstein J et al (2008) Prevalence and characteristics of lower urinary tract symptoms in men aged > or = 80 years. Urology 72:318

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mann RD, Biswas P, Fremantle S et al (2000) The pharmacovigilance of tamsulosin: event data on 12 484 patients. BJU Int 85:446–450

    Article  CAS  PubMed  Google Scholar 

  5. https://uroweb.org/guideline/treatment-of-non-neurogenic-male-luts/cLUTS. Zugegriffen: 21. November 2016

  6. Nickel JC, Sander S, Moon TD (2008) A meta-analysis of the vascular-related safety profile and efficacy of alpha-adrenergic blockers for symptoms related to benign prostatic hyperplasia. Int J Clin Pract 62:1547–1559

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. http://www.akdae.de/Arzneimittelsicherheit/Bekanntgaben/Archiv/2007/743-20070615.html. Zugegriffen: 21. November 2016

  8. http://www.enzyklopaedie-dermatologie.de. Zugegriffen: 21. November 2016

  9. Teper JS, Dobrowolski D, Wylegala E (2011) Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers. Cent European J Urol 64:62–66

    Article  Google Scholar 

  10. van Dijk MM, de la Rosette JJ, Michel MC et al (2006) Effects of alpha(1)-adrenoceptor antagonists on male sexual function. Drugs 66:287–301

    Article  PubMed  Google Scholar 

  11. Stojanović N, Ignjatović I, Djenić N et al (2015) Adverse effects of pharmacological therapy of benign prostatic hyperplasia on sexual function in men. Srp Arh Celok Lek 143:284–289

    Article  PubMed  Google Scholar 

  12. Chapple CR, Montorsi F, Tammela TL et al (2011) Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe. Eur Urol 59:342–352

    Article  CAS  PubMed  Google Scholar 

  13. Höfner K, Claes H, De Reijke TM et al (1999) Tamsulosin 0.4 mg once daily: effect on sexual function in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Eur Urol 36:335–341

    Article  PubMed  Google Scholar 

  14. Spagnul SJ, Cabral PH, Verndl DO et al (2011) Adrenergic α‑blockers: an infrequent and overlooked cause of priapism. Int J Impot Res 23:95–98

    Article  CAS  PubMed  Google Scholar 

  15. Yoon H, Yoon HS, Lee YS et al (2016) Effect of tamsulosin in lower urinary tract symptom patients with metabolic syndrome. Urology 88:135–142

    Article  PubMed  Google Scholar 

  16. Eber B, Weber T (2000) Alpha 1‑Rezeptoren-Blocker in der Hypertoniebehandlung. J Kardiol 7:97–83

    Google Scholar 

  17. McDonagh MS, Selover D, Santa J et al (2009) Drug class review: agents for overactive bladder. Final Report Update 4. Oregon Health & Science University, Portland

    Google Scholar 

  18. Shamliyan T, Wyman J, Kane RL (2012) Nonsurgical treatments for urinary incontinence in adult women: diagnosis and comparative effectiveness. Comparative Effectiveness Review, Bd. 36. Agency for Healthcare Research and Quality, Rockville, MD 20857

    Google Scholar 

  19. Nova G, Galfano A, Secco S et al (2008) A systematic review and meta-analysis of randomized controlled trials with antimuscarinic drugs for overactive bladder. Eur Urol 54:740–764

    Article  Google Scholar 

  20. Sink KM, Thomas J, Xu H et al (2008) Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes. J Am Geriatr Soc 56:847–853

    Article  PubMed  PubMed Central  Google Scholar 

  21. The American Geriatrics Society (2012) American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 60:616–631

    Article  Google Scholar 

  22. Pietzko A, Dimple W, Schwantes U et al (1994) Influences of trospium chloride and oxybutynin on quantitative EEG in healthy volunteers. Eur J Clin Pharmacol 47:337–343

    Article  CAS  PubMed  Google Scholar 

  23. Todorova A, Vonderheid-Guth B, Dimple W (2001) Effects of tolterodine, trospium chloride, and oxybutynin on the central nervous system. Urology 174:588–588

    Google Scholar 

  24. Kay G, Maruff P, Scholfield D et al (2012) Evaluation of cognitive function in healthy older subjects treated with fesoterodine. Neurourol Urodyn 30:961–963

    Google Scholar 

  25. Rittmaster RS, Norman RW, Thomas LN (1996) Evidence for atrophy and apoptosis in the prostates of men given finasteride. J Clin Endocrinol Metab 81:814–819

    CAS  PubMed  Google Scholar 

  26. Naslund MJ, Miner M (2007) A review of the clinical efficacy and safety of 5alpha-reductase inhibitors for the enlarged prostate. Clin Ther 29:17–25

    Article  CAS  PubMed  Google Scholar 

  27. Chiriacò G, Cauci S, Mazzon G (2016) An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia. Andrology 4:245–250

    Article  PubMed  Google Scholar 

  28. http://www.urologielehrbuch.de/5alpha_reduktasehemmer.html. Zugegriffen: 21. November 2016

  29. Traish AM, Hassani J, Guay AT (2011) Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med 8:872–884

    Article  CAS  PubMed  Google Scholar 

  30. Irwig MS (2012) Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects. J Clin Psychiatry 73:1220–1223

    Article  CAS  PubMed  Google Scholar 

  31. Lin WL, Hsieh YW, Lin CL et al (2015) A population-based nested case-control study: the use of 5‑alpha-reductase inhibitors and the increased risk of osteoporosis diagnosis in patients with benign prostate hyperplasia. Clin Endocrinol (Oxf) 82(4):503–508

    Article  CAS  Google Scholar 

  32. Hsieh TF, Yang YW, Lee SS et al (2015) Use of 5‑alpha-reductase inhibitors did not increase the risk of cardiovascular diseases in patients with benign prostate hyperplasia: a five-year follow-up study. PLOS ONE 10(3):e0119694

    Article  PubMed  PubMed Central  Google Scholar 

  33. Hoque A, Yao S, Till C, Kristal AR et al (2015) Effect of finasteride on serum androstenedione and risk of prostate cancer within the prostate cancer prevention trial: differential effect on high- and low-grade disease. Urology 85(3):616–620

    Article  PubMed  PubMed Central  Google Scholar 

  34. Andriole GL, Bostwick DG, Brawley OW et al (2010) REDUCE Study Group. Effect of dutasteride on the risk of prostate cancer. N Engl J Med 362(13):1192–1202

    Article  CAS  PubMed  Google Scholar 

  35. Morelli A et al (2011) Phosphodiesterase type 5 expression in human and rat lower urinary tract tissues and the effect of tadalafil on prostate gland oxygenation in spontaneously hypertensive rats. J Sex Med 8:2746

    Article  CAS  PubMed  Google Scholar 

  36. Vignozzi L et al (2013) PDE5 inhibitors blunt inflammation in human BPH: a potential mechanism of action for PDE5 inhibitors in LUTS. Prostate 73:1391

    Article  CAS  PubMed  Google Scholar 

  37. Gacci M et al (2012) A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol 61:994

    Article  CAS  PubMed  Google Scholar 

  38. Croxtall JD, Lyseng-Williamson KA (2010) Tadalafil: in pulmonary arterial hypertension. Drugs 70(4):479–488

    Article  CAS  PubMed  Google Scholar 

  39. Nitti VW, Rosenberg S, Mitcheson DH et al (2013) Urodynamics and safety of the β3-adrenoceptor agonist mirabegron in males with lower urinary tract symptoms and bladder outlet obstruction. J Urol 190(4):1320–1327

    Article  CAS  PubMed  Google Scholar 

  40. Chapple CR et al (2013) Randomized double-blind, active-controlled phase 3 study to assess 12-month safety and efficacy of mirabegron, a beta(3)-adrenoceptor agonist, in overactive bladder. Eur Urol 63:296

    Article  CAS  PubMed  Google Scholar 

  41. Herschorn S et al (2013) A phase III, randomized, double-blind, parallel-group, placebo-controlled, multicentre study to assess the efficacy and safety of the beta(3) adrenoceptor agonist, mirabegron, in patients with symptoms of overactive bladder. Urology 82:313

    Article  PubMed  Google Scholar 

  42. Khullar V et al (2013) Efficacy and tolerability of mirabegron, a beta(3)-adrenoceptor agonist, in patients with overactive bladder: results from a randomised European-Australian phase 3 trial. Eur Urol 63:283

    Article  CAS  PubMed  Google Scholar 

  43. Nitti VW et al (2013) Results of a randomized phase III trial of mirabegron in patients with overactive bladder. J Urol 189:1388

    Article  CAS  PubMed  Google Scholar 

  44. http://www.basg.gv.at/fileadmin/user_upload/150909_Betmiga.pdf. Zugegriffen: 21. November 2016

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Correspondence to S. Madersbacher.

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J. Wolfesberger, C. E. Falkensammer und S. Madersbacher geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Wolfesberger, J., Falkensammer, C.E. & Madersbacher, S. Blasenspeicher- und Entleerungsstörungen. Urologe 56, 456–464 (2017). https://doi.org/10.1007/s00120-017-0339-y

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  • DOI: https://doi.org/10.1007/s00120-017-0339-y

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