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Prosultiamine for treatment of lower urinary tract dysfunction accompanied by human T‐lymphotropic virus type 1‐associated myelopathy/tropical spastic paraparesis
Author(s) -
Matsuo Tomohiro,
Miyata Yasuyoshi,
Nakamura Tatsufumi,
Satoh Katsuya,
Sakai Hideki
Publication year - 2018
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13468
Subject(s) - medicine , overactive bladder , dyssynergia , urology , tropical spastic paraparesis , creatinine , urinary system , myelopathy , pathology , spinal cord , alternative medicine , psychiatry
Objectives To evaluate oral prosultiamine treatment in patients with overactive bladder accompanied by human T‐lymphotropic virus type 1‐associated myelopathy/tropical spastic paraparesis. Methods This was a prospective, single‐center, open‐label study. Patients received oral prosultiamine (300 mg) once daily in the morning, and the overactive bladder symptom score and urine levels of overactive bladder‐related biomarkers (nerve growth factor/creatinine and adenosine triphosphate/creatinine) 12 weeks after the initial administration were compared with the baseline values. In addition, the urodynamic parameters, including involuntary detrusor contraction and detrusor sphincter dyssynergia, were evaluated before and after treatment. Results A total of 16 patients were recruited for this clinical study. In the overactive bladder symptom score, night‐time frequency, urgency and the total score improved after oral prosultiamine treatment ( P = 0.028, 0.001 and 0.004, respectively). Both urinary nerve growth factor/creatinine and adenosine triphosphate/creatinine levels decreased significantly after the treatment ( P = 0.004 and 0.017, respectively). Urodynamic studies showed that the maximum cystometric capacity increased significantly after the treatment. However, the symptoms disappeared because of the treatment in six of 10 patients with involuntary detrusor contraction (60%) and three of seven patients with detrusor sphincter dyssynergia (42.9%). There were no serious adverse events. Conclusions The changes in urodynamic parameters and urine levels of overactive bladder‐related markers suggest that oral prosultiamine is a safe and effective treatment for overactive bladder with human T‐lymphotropic virus type 1‐associated myelopathy/tropical spastic paraparesis.