alpha-Blockade improves symptoms suggestive of bladder outlet obstruction but fails to relieve it.
OBJECTIVE
We investigated the effect of the alpha-blockers alfuzosin, terazosin and tamsulosin on urodynamic parameters after 6 months of therapy.


METHODS
Between February 1992 and June 1998, 163 patients with lower urinary tract symptoms suggestive of bladder outlet obstruction were treated with alfuzosin (60), terazosin (66) and tamsulosin (37). Patients were evaluated with urodynamic studies, including pressure flow analysis, before treatment and after 6 months of therapy. Initially, all patients were also assessed by the International Prostate Symptom Score questionnaire and measurement of urinary flow rate.


RESULTS
The majority of patients had no clear improvement in obstructive parameters, regardless of the alpha-blocker used, as urethral resistance factor and detrusor pressure maximum flow rate decreased by only 4 cm. H2O. There was a clear subjective and statistically significant decrease in International Prostate Symptom Score and quality of life scores of 6 and 2 points, respectively. No relevant statistical difference was noted among the effects of the 3 alpha-blockers on relieving symptoms or improving urodynamic parameters of obstruction.


CONCLUSIONS
The alpha-blockers are effective for treating symptoms suggestive of bladder outlet obstruction in patients presenting with lower urinary tract symptoms but not for treating the obstruction.
Rossi
C
C
Department of Urology, University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Kortmann
B B
BB
Sonke
G S
GS
Floratos
D L
DL
Kiemeney
L A
LA
Wijkstra
H
H
de la ROSETTE
J J
JJ
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000031:analogs & derivatives / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000627:therapeutic use; D000077409:Tamsulosin; D013997:Time Factors; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000188:drug therapy*; D014563:Urodynamics / Q000187:drug effects*
D000317:Adrenergic alpha-Antagonists; D011799:Quinazolines; D013449:Sulfonamides; C041226:Terazosin; C047638:alfuzosin; D000077409:Tamsulosin; D011224:Prazosin