The effect of terazosin on functional bladder outlet obstruction in women: a pilot study.
OBJECTIVE
We assessed the effect of terazosin (Hytrin(R)) on functional bladder outlet obstruction in women.


METHODS
Functional bladder outlet obstruction was defined as a maximum flow rate of less than 12 ml per second combined with a detrusor pressure at maximum flow rate of more than 20 cm H2O in pressure flow studies in the absence of neurological disorders or mechanical causes. In a prospective pilot study 15 women with functional bladder outlet obstruction were treated with terazosin. Terazosin was initiated at 1 mg daily and gradually increased to the maintenance dose of 5 mg daily during 2 weeks. Symptoms and urodynamic parameters were assessed before and 3 to 4 weeks after the initiation of alpha-blocker therapy.


RESULTS
While on terazosin, voiding symptoms subjectively improved greater than 50% in 10 of the 15 women (p = 0.002). Median maximum urethral closure pressure at rest decreased significantly from 98 to 70 cm H2O (p = 0.001), median maximum detrusor pressure decreased from 45 to 35 cm H2O (p = 0.008), median detrusor pressure at maximum flow decreased from 34 to 27 ml per second and median post-void residual urine decreased from 120 to 40 ml (p = 0.006 and 0.002, respectively). There was a significant increase in the median maximum flow rate from 9 to 20 ml per second and in median voided volume from 300 to 340 ml (p = 0.0005 and 0.021, respectively). Storage symptoms, functional urethral length and maximum cystometric capacity did not change significantly with alpha-blocker therapy (p > 0.05). Overall terazosin resulted in a significant improvement in symptoms and urodynamic parameters in 10 of the 15 women (67%).


CONCLUSIONS
Terazosin had a significant symptomatic and urodynamic effect in two-thirds of our patients. These results suggest that terazosin may be an effective treatment option in women with voiding dysfunction due to functional bladder outlet obstruction.
Kessler
Thomas M
TM
Department of Urology, University of Bern, Bern, Switzerland.
Studer
Urs E
UE
Burkhard
Fiona C
FC
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011224:Prazosin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D001748:Urinary Bladder Neck Obstruction / Q000188:drug therapy* / Q000503:physiopathology; D014554:Urination / Q000502:physiology; D014563:Urodynamics
D000317:Adrenergic alpha-Antagonists; C041226:Terazosin; D011224:Prazosin