title: Comparison of the efficacy of isosorbide mononitrate and doxazosin in the treatment of lower urinary tract symptoms and benign prostatic hyperplasia: a randomized clinical trial.
abstract: OBJECTIVE
  We aimed to compare the efficacy of isosorbide mononitrate and doxazosin in the treatment of lower urinary tract symptoms (LUTS).
  
  
  METHODS
  80 patients with LUTS were included in this randomized clinical study. All patients were evaluated with uroflowmetry, post-void residual (PVR) urine, prostate volume, International Prostate Symptom Score (IPSS), serum PSA, urinalysis and culture. 40 patients were prescribed doxazosin for 4 weeks, another 40 were prescribed isosorbide mononitrate for 4 weeks. Urologic re-evaluation was done at the end of the study.
  
  
  RESULTS
  74 patients completed the study. The mean age of patients was 59.6 ± 0.7 years, the mean PSA value was 1.7 ± 0.1 ng/ml and the mean prostate volume was 41.9 ± 1.7 ml. Doxazosin markedly improved IPSS (from 16.2 ± 0.7 to 9.5 ± 0.5), maximum urinary flow rate (from 10.9 ± 0.7 to 12.8 ± 0.6 ml/s) and PVR urine (from 68.1 ± 9.4 to 39.0 ± 4.4 ml) (p < 0.0001, p < 0.0001, p = 0.0004, respectively). Isosorbide only improved IPSS (from 16.5 ± 0.9 to 14.6 ± 0.8) (p = 0.032).
  
  
  CONCLUSIONS
  Daily administration of isosorbide does not seem to be an alternative to α-blocker therapy. Controlled, randomized novel studies are required to establish that whether nitric oxide donors are an effective alternative in LUTS treatment.
authors.affiliation: Kartal Training and Research Hospital Urology Clinic, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tarhan
authors.forename: Osman
authors.initials: O
authors.lastname: Çelik
authors.forename: Çağatay
authors.initials: Ç
authors.lastname: Tosun
authors.forename: Gökhan
authors.initials: G
authors.lastname: Faydacı
authors.forename: Bilal
authors.initials: B
authors.lastname: Eryıldırım
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D017292:Doxazosin / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D020030:Nitric Oxide Donors / Q000008:administration & dosage / Q000627:therapeutic use; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D016055:Urinary Retention / Q000188:drug therapy
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D020030:Nitric Oxide Donors; D009569:Nitric Oxide; D017430:Prostate-Specific Antigen; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate; D017292:Doxazosin