title: [Role of alpha antagonists in uncoordinated micturition syndrome in childhood].
abstract: BACKGROUND
  Dysfunctional voiding syndrome in children is characterized by a pattern of dysfunctional bladder emptying due to an active contraction of the external sphincter during micturition. Diagnosis is based on electromyographic and flowmetry results. The treatment is focused on relaxing the external sphincter during micturition where biofeedback is the treatment of choice. By the moment there are still centres without this possibility, alpha blockers are an alternative.
  
  
  OBJECTIVE
  To determine the efficacy of alpha blockers as an alternative to biofeedback as a therapeutic possibility.
  
  
  METHODS
  We included a total of 17 children with dysfunctional voiding syndrome and carried out a retrospective study. We registered age, symptoms at diagnosis, presence of associated urologic problems, flowmetry results pre and post-treatment, type of treatment used and its effectiveness comparing patients treated with alpha blockers and those who are starting to deal with biofeedback.
  
  
  RESULTS
  There were 12 girls and 5 boys. The mean age at diagnosis was 4.9 years old, 88% of these children related enuresis, diurnal urinary incontinence and urgency, 57% of them had also urinary infections, 63% constipation, 36% had psychosocial problems. Ten patients were treated with alpha-antagonists: 6 with Tamsulosin and 4 with Doxazosin. They followed this treatment an average of 5.8 months, range between 2 and 12 months. Five patients were treated with biofeedback. All cases had an abnormal pelvic electromyography. Patients treated with alpha-blockers achieved a 70% of electromyographic improvement with a 70% of recurrence. In children treated with biofeedback we got improvement in 80% with no recurrence. After alpha blocker therapy, maximum flow rates and average flow values were better but not statistically significant, this difference was significant with biofeedback. A patient treated with Tamsulosin left treatment due to hypotension, 2 patients left Doxazosin because of dizziness.
  
  
  CONCLUSIONS
  Alpha-blockers are effective in the treatment of dysfunctional voiding syndrome with a high percentage of recurrence. They can be an alternative to biofeedback but this one is the effective and definitive treatment.
authors.affiliation: Servicio de Cirugía Pediátrica, Complejo Hospitalario Universitario La Coruña. memoli92@hotmail.com
authors.forename: M E
authors.initials: ME
authors.lastname: Molina Vázquez
authors.forename: I
authors.initials: I
authors.lastname: Somoza Arguibay
authors.forename: M G
authors.initials: MG
authors.lastname: Palacios
authors.forename: J R
authors.initials: JR
authors.lastname: Gómez Veiras
authors.forename: M
authors.initials: M
authors.lastname: González
authors.forename: M
authors.initials: M
authors.lastname: Tellado
authors.forename: E
authors.initials: E
authors.lastname: Pais
authors.forename: T
authors.initials: T
authors.lastname: Dargallo
authors.forename: D
authors.initials: D
authors.lastname: Vela
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017292:Doxazosin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D013577:Syndrome; D000077409:Tamsulosin; D014555:Urination Disorders / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin; D017292:Doxazosin