Novel pharmacotherapeutic avenues for bladder storage dysfunction in men

ABSTRACT

Introduction

Bladder storage dysfunction is associated with low quality of life in men and remains a challenging field in pharmacotherapy because of low persistence followed by patient-perceived lack of efficacy and adverse effects. The persistent desire for the development of novel pharmacotherapy is evident, leading to numerous research efforts based on its pathophysiology.

Areas covered

This review describes the pathophysiology, current pharmacotherapeutic strategies, and emerging novel drugs for male bladder storage dysfunction. The section on emerging pharmacotherapy provides an overview of current research, focusing on high-potential target molecules, particularly those being evaluated in ongoing clinical trials.

Expert opinion

As pharmacotherapies targeting alpha-adrenergic, beta-adrenergic, and muscarinic receptors – the current primary targets for treating male bladder storage dysfunction – have demonstrated insufficient efficacy and side effects, researchers are exploring various alternative molecular targets. Numerous targets have been identified as central to regulating bladder afferent nerve activity, and their pharmacological effects and potential have been evaluated in animal-based experiments. However, there is a limited number of clinical trials for these new pharmacotherapies, and they have not demonstrated clear superiority over current treatments. Further research is needed to develop new effective pharmacotherapies for bladder storage dysfunction in men.

KEYWORDS:

• Bladder outlet obstruction
• endocannabinoid
• overactive bladder
• P2X3 receptor
• transient receptor potential channels

Article highlights

• Male bladder storage dysfunction can negatively impact the quality of life and often exhibits lower persistence with pharmacotherapy.

• Primary pharmacotherapy options for this condition include alpha-blockers, beta-3 agonists, and antimuscarinics.

• Various new molecular targets for pharmacotherapy have shown promise in preclinical experiments.

• Superiority of emerging pharmacotherapy over current treatments remains unproven.

• Clinical and preclinical studies are necessary to determine the superiority of new treatment targets over current options.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.