前立腺肥大症に合併した過活動膀胱患者へのα1遮断薬と抗コリン薬の併用療法―シロドシンとイミダフェナシンの併用効果

Combination therapy with an α1 adrenergic antagonist and an anti-cholinergic agent for patients with prostatic hypertrophy associated with an overactive bladder: Combined effects of silodosin and imidafenacin

　前立腺肥大症における排尿障害は，排尿症状のみならず蓄尿症状を伴うことが少なくない。その治療にα₁遮断薬が繁用されるが，蓄尿症状の改善が不十分，または改善まで長期間を要する症例も存在する。筆者らは，前立腺肥大症により排尿症状と蓄尿症状を併せ持つ34症例を対象に，α₁遮断薬を投与後に抗コリン薬を併用した症例とα₁遮断薬のみ投与した症例との2群で治療効果を比較検討した。その結果，国際前立腺症状スコア（IPSS）と過活動膀胱症状スコア（OABSS）からα₁遮断薬と抗コリン薬の併用により排尿症状と蓄尿症状のすみやかな改善が認められ，安全性にも問題がなかった。α₁遮断薬と抗コリン薬の併用は，前立腺肥大症に伴う排尿障害の治療にとって有用な選択肢となり得る。

　Dysuria associated with prostatic hypertrophy is accompanied not only by voiding symptoms but also storage symptoms in many cases. Although α₁ adrenergic blockers are frequently administered for treatment,improvement of the storage symptoms is insufficient,and long-term treatment is necessary in some cases. We divided 34 patients with both voiding and storage symptoms associated with prostatic hypertrophy into 2 groups：one group was treated with an α₁ adrenergic blocker followed by an anti-cholinergic drug,and another group was treated with an α₁ adrenergic blocker alone,and compared the therapeutic effects. On IPSS and OABSS,both voiding and storage symptoms were rapidly improved by the combination of the α₁ adrenergic blocker and an anti-cholinergic drug without side effect. The combination of an α₁ adrenergic blocker and an anti-cholinergic drug may be a useful choice for the treatment of dysuria associated with prostatic hypertrophy.