偽麻黃鹼與抗組織胺對男性泌尿系統之影響
李承哲、邵翊紘、張英勛、謝明里
林口長庚紀念醫院外科部泌尿外科
The impact of pseudoephedrine and antihistamine on male lower urinary tract symptoms
Chen-Che Lee, I-Hung Shao, Ying-Hsu Chang, Ming-Li Hsieh
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou
Purpose: In our earlier study, we investigated the effect of pseudoephedrine on voiding and storage dysfunction in male without previous lower urinary tract symptoms. We found out that IPSS scores increase significantly after medication in patients over age of 50. Now, we liked to not only expand our study number and also compare pseudoephedrine to antihistamine, another medication that was commonly used for treating rhinitis that may cause lower urinary tract symptoms (LUTS). Also, post voiding volume was checked in order for more subjective measurements of voiding function.
Materials and Methods: We prospectively enrolled 200 male patients attending to ENT OPD due to rhinitis, from August 2015 to August 2016. They were then randomized to pseudoephedrine or antihistamine if no contraindication. International Prostate Symptom Score (IPSS score) and post voiding residual urine (PVR) were check before and after one week of treatment. The results were then analyzed with SPSS.
Results: There were no significant differences in the characteristic of both pseudoephedrine and antihistamine groups. A trend of increasing IPSS-T, IPSS-V and IPSS-S score were seen in the pseudoephedrine group, however didn’t reached significant. Similar result of IPSS-T and IPSS-V showed in antihistamine group, however not IPSS-S score. We then divided patients into age ≧ 50 and < 50 years old. There is a significant increase of IPSS-T score in patients ≧50 years old treated with pseudoephedrine, which is not observed in the other antihistamine group. An increase of IPSS-V score were seen in patients age <50 treated with antihistamine. The post voiding volume does not significantly change after treatment of both drugs, with a trend of increasing in patients with baseline IPSS-T score ≧7 treated with pseudoephedrine.
Conclusion: Both pseudoephedrine and antihistamine affects little on lower urinary tract function in general populations. However, pseudoephedrine causes worse IPSS-T scores in elderly male, whereas antihistamines cause worse IPSS-V scores in younger group. In subclinical voiding dysfunction patients with IPSS-T ≧7, pseudoephedrine may cause more post voiding residual urine. Thus in elderly patients with rhinitis, antihistamine may be more favorable, where pseudoephedrine may be more considered over antihistamine in younger patients