title: [Alterations in blood circulation of vesicourethral segment in men with neurogenic and non-neurogenic lower urinary tract symptoms].
abstract: OBJECTIVE
  To specify the pathogenetic link between blood supply of the bladder neck and lower urinary tract symptoms (LUTS).
  
  
  METHODS
  The study involved 78 men aged 26 to 50 years, including 19 patients with multiple sclerosis (MS) and LUTS, 29 patients with chronic prostatitis category IIIB with LUTS and 30 patients with chronic prostatitis category IIIB without LUTS (control group). All the patients underwent Doppler ultrasonography of prostatic arteries and selective study of blood flow in the neck of the bladder. Pharmacological test using combinations of 1-blockers (1-AB) with m-anticholinergics (m-CB) and phosphodiesterase type 5 inhibitors (PDEI-5).
  
  
  RESULTS
  The changes in the blood circulation of VUS were found to correlate with LUTS. The response of blood flow depended not only on the type of pharmacological agents, but also on the degree of vascular changes and neurological deficit in VUS.
  
  
  CONCLUSIONS
  The findings of VUS vascular pharmacological tests with PDEI-5 and 1-AB + m-CB were comparable in chronic prostatitis with non-neurogenic LUTS and in MS with neurogenic LUTS. Vascular reaction in VUS depends on the presence of neurological deficit. The combination of (1-AB+ m-CB) increases the blood circulation of the bladder neck and prostate and reduces the LUTS. PDEI-5 reduces LUTS due to the positive effect on the blood circulation of the prostate and VUS.
  
  
  CONCLUSIONS
  Circulatory abnormalities (=hypoxia) in VUS is an important pathogenetic mechanism of neurogenic and non-neurogenic LUTS and the way to compensate them using a combination of (1-AB+ m-CB) or PDEI-5. Therefore, one of the mechanisms of LUTS is associated with impaired blood flow in the bladder neck and VUS.
authors.affiliation: Clinic of Urology, I.M. Sechenov First MSMU.
authors.forename: Yu G
authors.initials: YG
authors.lastname: Alayev
authors.affiliation: Neurology Research Department at Scientific Research Center I.M. Sechenov First MSMU.
authors.forename: Yu M
authors.initials: YM
authors.lastname: Esilevskiy
authors.affiliation: Neurology Research Department at Scientific Research Center I.M. Sechenov First MSMU.
authors.forename: T E
authors.initials: TE
authors.lastname: Shmidt
authors.affiliation: Clinic of Urology, I.M. Sechenov First MSMU.
authors.forename: Yu L
authors.initials: YL
authors.lastname: Demidko
authors.affiliation: Clinic of Urology, I.M. Sechenov First MSMU.
authors.forename: D N
authors.initials: DN
authors.lastname: Fiev
authors.affiliation: Neurology Research Department at Scientific Research Center I.M. Sechenov First MSMU.
authors.forename: K Yu
authors.initials: KY
authors.lastname: Kazantsev
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage / Q000494:pharmacology; D000328:Adult; D006439:Hemodynamics; D006801:Humans; D000860:Hypoxia; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000494:pharmacology; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage; D011467:Prostate / Q000098:blood supply / Q000000981:diagnostic imaging; D012039:Regional Blood Flow / Q000187:drug effects; D018608:Ultrasonography, Doppler; D014521:Urethra / Q000098:blood supply*; D001743:Urinary Bladder / Q000098:blood supply*; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D018727:Muscarinic Antagonists; D058986:Phosphodiesterase 5 Inhibitors
keywords: PDE type 5 inhibitors; blood flow to the bladder neck; chronic prostatitis; erectile dysfunction; lower urinary tract symptoms; multiple sclerosis; peripheral nervous system blockers