Int Neurourol J.  2014 Dec;18(4):221-225. 10.5213/inj.2014.18.4.221.

4-Aminopyridine Improves Lower Urinary Tract Symptoms in a Patient With Benign Prostatic Hyperplasia and Downbeat Nystagmus Syndrome

Affiliations
  • 1Department of Neurology, University Hospital Munich, Campus Grosshadern, Munich, Germany. michael.strupp@med.uni-muenchen.de
  • 2German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Grosshadern, Munich, Germany.
  • 3Department of Urology, University Hospital Munich, Campus Grosshadern, Munich, Germany.

Abstract

Aminopyridines are potassium channel blockers that increase the excitability of nerve cells and axons; therefore, they are widely used to treat different neurological disorders. Here we present a patient with idiopathic downbeat nystagmus and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia who was treated with the sustained-release form of 4-aminopyridine (4-AP). During treatment with 4-AP, the LUTS improved. This improvement was monitored by using uroflowmetry and the International Prostate Symptom Score. A significant improvement of symptoms was observed in relation to the voided volume. This included an improved emptying of the bladder without an increase in residual urine. In animal studies, both nonselective K+ channel blockade and selective voltage-sensitive potassium blockade by 4-AP resulted in increased contraction on rat detrusor strips. To our knowledge, this is the first clinical observation of the mode of action of 4-AP in urological symptoms in humans.

Keyword

4-Aminopyridine; Prostatic Hyperplasia; Lower Urinary Tract Symptoms; Drug Therapy; Neurogenic Urinary Bladder

MeSH Terms

4-Aminopyridine*
Aminopyridines
Animals
Axons
Drug Therapy
Humans
Lower Urinary Tract Symptoms*
Nervous System Diseases
Neurons
Potassium
Potassium Channel Blockers
Prostate
Prostatic Hyperplasia*
Rats
Urinary Bladder
Urinary Bladder, Neurogenic
4-Aminopyridine
Aminopyridines
Potassium
Potassium Channel Blockers
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