[Urodynamic criteria of predicting efficacy of therapy with alpha1-adrenergic blockaders in patients with benign prostatic hyperplasia].
OBJECTIVE
As baseline urodynamic parameters do not correlate well with response to medical treatment for lower urinary tract symptoms (LUTS), this study was designed to asertain whether urodynamic parameters correlate better with response to alpha 1-adrenoblockers.


METHODS
23 men (mean age 64.6 +/- 9.3 years) with LUTS have undergone urodynamic examination prior to initiating therapy with terazosin titrated to 5 mg and followed for 2.5 months. Parameters of evaluation included IPSS symptom score, peak flow rate (Qmax), maximal detrusor pressure (Pmax), detrusor pressure at maximal flow (Pdet) and detrusor contraction duration (DCD). The correlation and predictive value of therapeutic response and baseline urodynamic parameters were assessed.


RESULTS
For the entire group, IPSS decreased from 13.25 +/- 3.39 to 7.38 +/- 3.21 (44.6%), Qmax increased from 9.75 +/- 1.95 to 11.00 +/- 3.23 ml/s (21%), Pmax decreased from 109.75 +/- 35.72 to 93.88 +/- 20.91 cm. H2O (14.4%), Pdet decreased from 84.00 +/- 23.71 to 74.00 +/- 15.53 cm. H2O (16.8%), DCD increased from 127.63 +/- 53.99 to 130.13 +/- 45.41s (2.7%). There was a weak correlation between either Pmax or Pdet and therapeutic response (defined as a IPSS decrease of 40% and an increase in Qmax of 30%). There was a significant correlation with therapeutic response of DCD > 60 s (p < 0.05, r = 0.56).


CONCLUSIONS
The pilot data suggest that DCD may be a useful urodynamic parameter to predict and optimize therapy with alpha 1-adrenoblockers.
Sivkov
A V
AV
Egorov
A A
AA
Romikh
V V
VV
Surikov
V N
VN
D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000503:physiopathology
D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists