online pharmacy, prescription drugs online



Drugs online research references








J Urol. 2002 Aug;168(2):571-4.
alpha1-Adrenergic blockers in young men with primary bladder neck obstruction.

Yang SS, Wang CC, Hsieh CH, Chen YT.

Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University and Taipei Medical University, Taiwan, Republic of China.

PURPOSE: We assessed the efficacy and safety of the mid term use of alpha1-adrenergic blockers for treating primary bladder neck obstruction in young and middle-aged men. MATERIALS AND METHODS: Between May 1998 and February 2001 primary bladder neck obstruction was diagnosed by videourodynamic study in 28 men younger than 55 years. The degree of obstruction was graded by the Schafer nomogram. Mean patient age and mean symptom duration were 39.3 years and 18.1 months, respectively. The presenting symptom was frequency in 22 cases (78.6%), urgency in 10 (35.7%), weak stream in 9 (32.1%), nocturia greater than 2 times in 7 (25%) and hesitancy in 7 (25%). A dose of 1 to 2 mg. doxazosin was administered at bedtime for at least 3 months. International Prostate Symptom Score (I-PSS), quality of life, uroflowmetry and post-void residual urine were assessed before and 3 months after medication. Improved urine flow was defined as at least a 2.5 ml. per second increase in the maximum flow rate. Improved symptoms was defined as more than a 50% decrease in I-PSS. Successful treatment was defined as improved urine flow and symptoms. RESULTS: Followup data were available in 24 patients. The medication period and followup were 7 and 12 months, respectively. Mean I-PSS plus or minus standard deviation decreased from 18.3 +/- 4.6 to 11.6 +/- 5.2 (p <0.01) and mean quality of life decreased from 4.1 +/- 1.1 to 2.6 +/- 1.0 (p <0.01). Mean maximum flow increased from 11.8 +/- 3.2 to 15.9 +/- 3.9 ml. per second (p <0.01). Mean post-void residual urine decreased from 80.2 +/- 17.1 to 48.5 +/- 10.3 ml. (p <0.01). Treatment was successful in 13 patients (54.2%) and 3 (12.5%) were free of medication for at least 6 months. More successful outcomes were noted in patients with high grades III to IV obstruction than in those with low grades 0 to II obstruction (80% versus 35.7%, p = 0.03). Before treatment higher detrusor pressure at maximum flow (70.1 versus 47.8 cm. water, p = 0.01) and lower maximum flow (10.6 versus 13.3 ml. per second, p = 0.02) were observed in patients with successful versus unsuccessful treatment, respectively. Differences in patient age, I-PSS, quality of life, prostate size and post-void residual urine were not statistically significant. No significant adverse effects were noted. CONCLUSIONS: alpha1-Blockers were effective and safe for treating young men with primary bladder neck obstruction.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12131312&dopt=Abstract




J Urol. 2002 Aug;168(2):587-92.
Critical evaluation of the problem of chronic urinary retention after orthotopic bladder substitution in women.

Ali-El-Dein B, Gomha M, Ghoneim MA.

Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

PURPOSE: We studied the possible causes of chronic retention after radical cystectomy and orthotopic bladder substitution in women. MATERIALS AND METHODS: Between January 1995 and January 2001, 136 women with a mean age plus or minus standard deviation of 52 +/- 8 years underwent standard radical cystectomy and orthotopic substitution for organ confined bladder cancer. Videourodynamics, pelvic floor electromyography, pelvic floor magnetic resonance imaging and pan-endoscopy were done. In the last 37 cases some technical modifications were adopted to circumvent the development of chronic urinary retention. RESULTS: One woman died postoperatively of massive pulmonary embolism. Of the 100 patients evaluable at a mean followup of 36 months 95 were continent in the daytime, 86 were continent at night, 2 were completely incontinent and 16 were in chronic retention. Videourodynamics showed that retention was mechanical in nature due to the pouch falling back in the wide pelvic cavity, resulting in acute angulation of the posterior pouch-urethral junction. In addition, herniation of the pouch wall through the prolapsed vaginal stump was observed in most cases. Pelvic floor electromyography demonstrated complete pelvic floor silence during voiding. No abnormality of the pelvic floor or rhabdosphincter was noted on magnetic resonance imaging. Pan-endoscopy showed a normal urethra with no urethroileal stricture. A 4 mg. dose of the alpha1-adrenergic blocker doxazosin daily was ineffective, excluding the possibility that sprouting from adjacent adrenergic neurons into the denervated proximal urethral muscles may have been the cause of this problem. After omental packing behind the pouch, suturing of the peritoneum on the rectal wall to the vaginal stump, suspension of the latter by the preserved round ligaments and suspension of the pouch near its dome to the back of the rectus muscle at cystectomy the incidence of chronic retention decreased from 18.7% (14 of 75 cases) before to 8% (2 of 25) after modifications. Furthermore, after vaginal wall descent was mechanically corrected by a pessary there was significant improvement in evacuation. CONCLUSIONS: Strong evidence was provided that chronic urinary retention after orthotopic substitution is due to anatomical rather than to functional or neurogenic reasons. Modifications to increase back support of the pouch with ventral suspension near its dome and support the vaginal stump are recommended to avoid this complication.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12131315&dopt=Abstract




Urology. 2002 Aug;60(2):351-6.
Effect of doxazosin on stretch-activated adenosine triphosphate release in bladder urothelial cells from patients with benign prostatic hyperplasia.

Sun Y, MaLossi J, Jacobs SC, Chai TC.

Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.

OBJECTIVES: Recent data suggest that the bladder urothelium may have a sensory function by way of release of adenosine triphosphate (ATP) during stretch, which then acts as a sensory neurotransmitter. Because benign prostatic hyperplasia (BPH) can give rise to irritative (hypersensory) voiding patterns, we questioned whether the bladder urothelium from patients with BPH released more ATP during in vitro stretch and whether doxazosin, an alpha(1)-adrenoceptor blocker, affects this purinergic mechanism. METHODS: Bladder urothelial biopsies from patients with BPH (n = 4) and controls (n = 4) were cultured using established techniques. In vitro stretch was performed with a Flexcell 2000 device that uses vacuum to deform the cell growth surface to impart a stretch force. Doxazosin (5 microM and 20 microM) was added to cells, and supernatants were collected at various points for ATP assay. ATP was assayed using the luciferin-luciferase reaction. ATP data were normalized to the time 0 value and expressed as a percentage of the baseline value. RESULTS: After 96 hours of stretch, the BPH urothelial cells released significantly more ATP than did the control urothelial cells (62.6% +/- 11.2% versus 24.2% +/- 5.4%, P = 0.005) and nonstretched BPH urothelial cells (62.6% +/- 11.2% versus 15.1% +/- 5.1%, P = 0.004). The augmented release of ATP by stretched BPH bladder urothelial cells was completely blocked by treatment with 20 microM doxazosin. CONCLUSIONS: Irritative voiding secondary to BPH may arise from increased ATP release by bladder urothelium during stretch. Doxazosin inhibits ATP release by way of an unknown mechanism that may or may not involve the alpha1-adrenoreceptor. Treatment for hypersensory voiding symptoms secondary to BPH might also target the urothelial purinergic pathway.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12137852&dopt=Abstract












online pharmacies || Hair Million herbal formula for hair loss and hair growth || Amoxicillin || Tramadol || Paxil || Rx Drugs USA, Prescription Drugs Online Pharmacy || Zithromax || online pharmacy || Antibiotics and prescription medications online literature || Antibiotics