前立腺疾患の病態生理と薬物治療

抄録

Men with benign prostatic hyperplasia (BPH) often experience symptoms of overactive bladder (OAB), and bladder outlet obstruction (BOO) is one of cause of BPH. It has been suggested that bladder myogenic microcontractions or micromotions may partly contribute to the development of urgency (bladder sensory (afferent) hypersensitivity) in OAB related to BOO. We have investigated the direct effects of drugs (anticholinergics, β3-adrenoceptor agonists, α1-adrenoceptor antagonists, PDE type5 inhibitors, etc.) on the bladder afferent function in rodents. In our results, almost all drugs may act on the bladder afferent function, and some of drug (e.g. mirabegron) inhibits the afferent activities through the suppression of the bladder myogenic microcontractions in normal or pathophysiological conditions.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) causes long-standing pain and/or storage symptoms including storage symptoms, such as urgency and frequency. It has been reported that CP/CPPS is possibly overlapping with symptoms in BPH.

In this symposium, I will introduce our recent studies using pathophysiological animal models with BOO or CP/CPPS.