ABOUT BPH

PROSTATE AND BLADDER IN BPH

Multifactorial condition affecting the prostate and the bladder^2,3

LUTS associated with BPH can be attributed to multiple factors including an enlarged prostate gland, increased smooth muscle tone within the prostate,
and/or bladder dysfunction.^2,3
Symptoms associated with BPH are classified as either obstructive
or irritative symptoms.^2,3
The obstructive symptoms—hesitancy/straining, incomplete emptying of the
bladder, intermittency, and weak stream—are related to bladder emptying.^2,3
The irritative symptoms—frequency, urgency, and nocturia—are related to
bladder storage.^2,3

LUTS=lower urinary tract symptoms.

BPH negatively
impacts the patient

Men seek medical attention for bothersome symptoms^4-6

In men with severe symptoms,
BPH can interfere with normal
daily activities, sleep, and sexual
functioning.^7-9
As the severity of obstructive
symptoms increases, the overall
well-being of the patient
is significantly decreased.¹⁰
While obstructive symptoms
of BPH are more common,
irritative symptoms are more
bothersome to patients and
may interfere with
daily activities.^4-6
Patients often seek BPH
treatment due to nocturia,
frequency, and urgency.^4-6

The role of α_1A receptors in BPH

α_1A blockade may improve both bladder storage and voiding function¹¹

Obstructive symptoms in BPH are the result of bladder outlet
obstruction (BOO) due to prostate enlargement and/or increased
α_1A-adrenergic activity.^2,12 α_1A receptors regulate smooth muscle
contraction in the prostate, bladder base and neck, and
urethra,^1,13,14 and blockade of α_1A receptors relieves obstructive
symptoms and improves urine flow.¹³
Voiding symptoms in BPH may be due to increased bladder
C-fiber activity.^11,12
α_1A receptors modulate bladder C-fiber afferent activity,^11,15 and
bladder storage function may improve with blockade of α_1A
receptors.^11,16*

*Findings may not correlate with actual clinical outcomes.

REFERENCES

RAPAFLO^® (silodosin) Capsules full Prescribing Information, Actavis Pharma Inc., October 2014.
American Urological Association. AUA guideline on management of benign prostatic hyperplasia (2010).
Andersson KE. Storage and voiding symptoms: pathophysiologic aspects. Urology. 2003;62(Suppl 5B):3-10.
Scarpa RM. Lower urinary tract symptoms: what are the implications for the patients? Eur Urol. 2001;40(Suppl 4):12-20.
Chartier-Kastler E, Tubaro A. The measurement of nocturia and its impact on quality of sleep and quality of life in LUTS/BPH. Eur Urol Supp. 2006;5:3-11.
Peters TJ, Donovan JL, Kay HE, et al. The International Continence Society "Benign Prostatic Hyperplasia" study: the bothersomeness of urinary symptoms. J Urol. 1997;157(3):885-889.
Bruskewitz RC. Quality of life and sexual function in patients with benign prostatic hyperplasia. Rev Urol. 2003;5(2):72-80.
Hernández C, Estivill E, Prieto M, Badía X. Nocturia in Spanish patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Curr Med Res Opin. 2008;24(4):1033-1038.
Roberts RO, Jacobsen SJ, Rhodes T, Girman CJ, Guess HA, Lieber MM. Natural history of prostatism: impaired health states in men with lower urinary tract symptoms. J Urol. 1997;157:1711-1717.
Issa MM, Regan TS. Medical therapy for benign prostatic hyperplasia—present and future impact. Am J Manag Care. 2007;13(Suppl 1):S4-S9.
Yokoyama O, Ito H, Aoki Y, Oyama N, Miwa Y, Akino H. Selective α_1A-blocker improves bladder storage function in rats via suppression of C-fiber afferent activity. World J Urol. 2010;28:609-614.
Komninos C, Mitsogiannis I. Obstruction-induced alterations within the urinary bladder and their role in the pathophysiology of lower urinary tract symptomatology. Can Urol Assoc J. 2014;8(7-8):e524-530.
Schwinn DA, Roehrborn CG. α₁-Adrenoceptor subtypes and lower urinary tract symptoms. Int J Urol. 2008;15:193-199.
Carbone DJ, Hodges S. Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life. Int J Impot Res. 2003;15:299-306.
Yazaki J, Aikawa K, Shishido K, et al. Alpha1-adrenoceptor antagonists improve bladder storage function through reduction of afferent activity in rats with bladder outlet obstruction. Neurourol Urodyn. 2011;30(3):461-467.
Cruz F, Desgrandchamps F. New concepts and pathophysiology of lower urinary tract symptoms in men. Eur Urol Supp. 2010;9(4):472-476.
Nasu K, Moriyama N, Kawabe K, et al. Quantification and distribution of α1-adrenoceptor subtype mRNAs in human prostate: comparison of benign hypertrophied tissue and non-hypertrophied tissue. Br J Pharmacol. 1996;119(5):797-803.
Murata S, Taniguchi T, Takahashi M, Okada K, Akiyama K, Muramatsu I. Tissue selectivity of KMD-3213, an α₁-adrenoceptor antagonist, in human prostate and vasculature. J Urol. 2000;164(2):578-583.
Townsend SA, Jung AS, Hoe YSG, et al. Critical role for the α-1B adrenergic receptor at the sympathetic neuroeffector junction. Hypertension. 2004;44(5):776-782.
Data on file, Watson Laboratories, Inc.
Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Rapid efficacy of the highly selective α_1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies. J Urol. 2009;181:2634-2640.
Kobayashi K, Masumori N, Hisasue S, et al. Inhibition of seminal emission is the main cause of anejaculation induced by a new highly selective α1A-blocker in normal volunteers. J Sex Med. 2008;5(9):2185-2190.

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ABOUT BPH

PROSTATE AND BLADDER IN BPH

Multifactorial condition affecting the prostate and the bladder2,3

BPH negatively impacts the patient

Men seek medical attention for bothersome symptoms4-6

The role of α1A receptors in BPH

α1A blockade may improve both bladder storage and voiding function11

Multifactorial condition affecting the prostate and the bladder^2,3

BPH negatively
impacts the patient

Men seek medical attention for bothersome symptoms^4-6

The role of α_1A receptors in BPH

α_1A blockade may improve both bladder storage and voiding function¹¹