Investigation On Mirabelon And Solifenacin In The Treatment Of Bladder Spasm After Transurethral Vaporize Electrotomy Prostate

Background and ObjectiveBPH(benign prostatic hyperplasia,BPH)is one of the most common disease in older men,with the advent of population aging,the incidence of BPH is higher and higher.The main symptoms of BPH are lower urinary tract symptoms(LUTS),including symptoms of urinary storage(irritation)and symptoms of urination(obstruction).Transurethral resection of the prostate(TURP)is still the gold standard for BPH.Transurethral vaporize electrotomy prostate(TUVEP)has been widely used as a modified version of TURP.Postoperative patients often indwelling balloon catheter to the area oppression hemostasis,due to the air bag to stimulate bladder caused by excessive activity of bladder outlet zone,and the majority of patients with BPH bladder detrusor instability,the postoperative patients often appear TUVEP bladder spasm,main show is the bladder detrusor contraction of autonomy,the intermittent abdominal cramps and pain with radiation to the perineum,patients can have a strong sense of urination,part can appear around the urine catheter to overflow.The selective cholinergic M3 receptor antagonist ensuring that new as TUVEP postoperative bladder spasm has been widely used in clinic,while its therapeutic effect is remarkable,the potential CNS-related adverse drug reactions in elderly patients deserve our attention.Mirabegron,as a kind of high efficient and selective ?3 agonists,is the only access to U.S.food and drug administration approved excessive activity can be used for bladder disease(overactive bladder,OAB)treatment of such drugs.Miraberon has just been introduced into China,and there is no clinical study on miraberon contrasted solifenacin to relieve bladder spasm after TUVEP.In order to reduce the incidence of postoperative bladder spasm,better manage postoperative patients' postoperative recovery and reduce the psychophysiological burden,this study conducted a comparative study on the relief of postoperative bladder spasm by mirabegron and solifenacin.Subjects and methodsAccording to the inclusion criteria,surgical patients diagnosed with BPH in the urology department of our hospital from September 2018 to December 2019 were included.The surgeons were all senior urologists of the first affiliated hospital of zhengzhou university.The anesthesia was general anesthesia.TUVEP was selected as the surgical method.After the operation,a 22Fr three-chamber silicone catheter was retained,and the balloon was filled to 50ml.Prevent bleeding by pulling the balloon compression area.Clinical intervention was carried out on the subjects by using a randomized single blind control method.The 80 subjects were divided into four groups,20 for each group.Solinazine group:single dose solinazine(Trade name:Weixikang),5mg,orally once a night;Mirabellon group:mirabellon(Trade name:Beitanli),50mg,orally once a night;Dual drug group:5mg solinazine,orally once a night,50mg miraberon,orally once a night;Control group:10mg Vitamin C tablets,orally once a night,psychophysical intervention if necessary.The observation period was within 7 days after the operation,that is,the starting point of the event was the first day after the operation,and the end point of the event was the removal of the catheter on the seventh day after the operation.Objective indexes and subjective indexes were recorded to analyze the remission differences and related clinical characteristics of postoperative bladder spasm in each group.ResultsA total of 80 subjects were included in this study,with 20 subjects in each group,all of whom successfully completed the surgery.During the postoperative follow-up,1 patient in the new solina group withdrew,2 patients in the dual-drug group withdrew,and the miraberon group and the control group all participated in the follow-up.In all observation items,there was no statistically significant differences between the solifenacin group and mirabegron group(P?0.05).In terms of spasm frequency,duration,VAS score and PPBC scale,the difference between solifenacin group and control group?mirabegron group and control group?control group and double drug group was statistically significant(P<0.05).In terms of QOL score,there was no statistically significant differences between the three groups(P?0.05).On the contrary,there were statistically significant difference between the three groups compared with the control group(P<0.05).In the subgroup analysis with the number of days after surgery as a variable factor,in terms of the number of spasms,duration and VAS score,there was no statistically significant differences between solifenacin group?mirabegron group and dual-drug group on the 6-7 days after surgery(P?0.05).In terms of frequency and duration of spasm,there was no statistically significant difference among the four observation groups on the 7th day after the operation(P>0.05).In this study,1 case(5.26%)of dry mouth and 7 cases(36.84%)of constipation occurred in the solifenacin group.5 cases(25.00%)of constipation occurred in mirabegron group.There were 1 case(5.00%)of blurred vision and 6 cases(33.33%)of constipation in the double-drug group.In the control group,4 patients(20.00%)were constipated.No increase in blood pressure or heart rate was observed in any of the patients.None of the patients had serious adverse events during the study.ConclusionMirabellon and solinasin are effective and safe in the treatment of bladder spasm within 6 days after TUVEP,and their therapeutic effects were comparable.It was recommended to use the combined therapy within 5 days after surgery,and the combined therapy is more effective without increasing drug-related adverse reactions.