Role of alpha adrenergic blocker in the management of posterior urethral valves.
OBJECTIVE
To evaluate the effect of Terazosin (alpha1 adrenergic blocker) on bladder emptying in children with posterior urethral valves.


METHODS
Forty-two children with significant post void residual urine after valves ablation were placed on Terazosin ranging from 0.25 to 2 mg. Post void urine at the commencement and at follow up was monitored with abdominal ultrasound.


RESULTS
Post void residual urine significantly reduced in 40 patients (95%) who were put on Terazosin. Mean pretreatment PVR was 15.7 ml and mean PVR at the last follow up was 2.4 ml (P = 0.000). This was a reduction of 85% in the pretreatment post void residual urine volume. All the patients had improvement in urinary stream. One patient reacted to Terazosin with hypotension necessitating its withdrawal. Mean follow up was 17 months.


CONCLUSIONS
Terazosin has proved to be safe and results in significant improvement in bladder emptying in our patients with posterior urethral valves. Randomized controlled trial and long-term follow up are necessary to further define the role of alpha1 adrenergic blocker therapy in children with posterior urethral valves. This study will become the justification for such a study.
Abraham
Mohan K
MK
Department of Pediatric Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrital Lane, Elamakkara P.O., Kochi, India. mohanabraham@aims.amrita.edu
Nasir
Abdul Rasheed A
AR
Sudarsanan
Bindu
B
Puzhankara
Ramakrishnan
R
Kedari
Prashant M
PM
Unnithan
Gopidas R
GR
Damisetti
Kalyan Ravi Prasad
KR
Narayanan
Tutu
T
D000284:Administration, Oral; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D003558:Cystoscopy; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011224:Prazosin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities* / Q000187:drug effects / Q000503:physiopathology; D001748:Urinary Bladder Neck Obstruction / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics / Q000187:drug effects
D000317:Adrenergic alpha-Antagonists; C041226:Terazosin; D011224:Prazosin