RESUMEN
OBJECTIVES: To update a syndrome that has increased the number of pathologies included such as obesity, hypertension, hypercholesterolemia, type II diabetes mellitus, and the recent addition of erectile dysfunction and androgen deficiency METHODS: Global review of bibliography taking the last articles as a reference and mainly those from Prof. M. Serrano Rios and his group in Madrid. RESULTS: Metabolic syndrome seems to be consolidated as a universally accepted term, despite its complex semantic and gnoseologic itinerary. The inclusion of erectile dysfunction and androgen deficiency gives more pathogenic solidity and makes the professional field of endocrinology closer to two mainly urological processes. The urologist has a new perspective of processes that are of his own, that he has to take care of in a comprehensive manner, with physical examination, blood tests and therapy. CONCLUSIONS: Metabolic syndrome may be more frequently than suspected recognized in the urologist office. Urologists are compelled, in this typically medical process, to exercise with more dedication and fullness the medical compromise of our medical-surgical specialty.
Asunto(s)
Disfunción Eréctil/etiología , Síndrome Metabólico/complicaciones , Humanos , Masculino , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/terapiaRESUMEN
OBJECTIVES: This paper profiles the usage and effectiveness of various LUTS/BPH drugs in real-life practice. METHOD: The TRIUMPH study recorded the treatment and outcomes of 2351 newly-presenting LUTS/BPH patients in 6 European countries over a 1-year follow-up period. At each visit the clinician recorded the treatment, co-morbidities, complications and drugs prescribed, and the patient completed an IPSS questionnaire. The results were analysed using change in IPSS as the primary outcome measure. RESULTS: Over the study period 74.9% of patients were prescribed medication, the majority (83% of those medicated) were prescribed only a single drug. Tamsulosin was the most commonly prescribed drug in all countries (38% of medicated cases), although with national variation from 24% in Poland to 70% in Italy. The alpha-blockers were the most effective, with a mean reduction of 6.3 IPSS points. Finasteride was slightly less effective (4.1 points). Significant improvements were seen in 43% of patients on phytotherapy with Serenoa repens or Pygeum africanum compared to 57% of those on finasteride and 68% on alpha-blockers. The only combination therapy found to produce a statistically significant improvement over the use of individual drugs was finasteride+tamsulosin (8.1 points compared to 6.7 for tamsulosin alone and 4.2 for finasteride alone). CONCLUSIONS: All drug treatments showed some improvement over watchful-waiting for most patients over the study period: the alpha-blockers were found to be the most effective. There were marked national differences in prescribing patterns, both in individual drug choice and in the use of combination therapies.