title: α1-Blockers for the treatment of recurrent urinary tract infections in women with dysfunctional voiding: a prospective randomized study.
abstract: OBJECTIVE
  To evaluate the therapeutic effects of tamsulosin on recurrent urinary tract infections in women with dysfunctional voiding.
  
  
  METHODS
  A total of 155 women with recurrent urinary tract infections and dysfunctional voiding were included and randomly assigned to the following groups: uroflowmetry biofeedback (group 1), α1-adrenoceptor antagonists (group 2), uroflowmetry biofeedback combined with α1-adrenoceptor antagonists (group 3) and no treatment (group 4). Patients were evaluated by the American Urological Association Symptom Index at 3, 6 and 12 months. Urodynamics was carried out in patients of groups 1, 2, and 3 at 3, 6 and 12 months, whereas urodynamics was only carried out at 12 months in group 4. All patients were followed up for 1 year with monthly urine cultures.
  
  
  RESULTS
  The incidence of storage and emptying symptoms decreased significantly at 3, 6 and 12 months. Mean flow rate, flow time and voiding volume increased significantly (with a better outcome in patients of group 3), whereas post-void residual urine decreased. Mean opening detrusor pressure and detrusor pressure at maximum flow decreased significantly (with a better outcome in patients of group 3). Mean urethral closure pressure and maximum urethral closure pressure decreased significantly with a more significant decrease for patients in group 3. The prevalence of urinary tract infection decreased significantly in all groups after treatment, and this decrease remained stable during the follow up.
  
  
  CONCLUSIONS
  In women with dysfunctional voiding and recurrent urinary tract infection, tamsulosin associated with uroflowmetry biofeedback might be an effective and safe treatment option for improving urinary symptoms and quality of life.
authors.affiliation: Department of Clinic and Specialistic Sciences, Institute of Urology, Polytechnic University of the Marche Region, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Minardi
authors.forename: Francesco
authors.initials: F
authors.lastname: Pellegrinelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conti
authors.forename: Donatella
authors.initials: D
authors.lastname: Fontana
authors.forename: Michela
authors.initials: M
authors.lastname: Mattia
authors.forename: Giulio
authors.initials: G
authors.lastname: Milanese
authors.forename: Giovanni
authors.initials: G
authors.lastname: Muzzonigro
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D014552:Urinary Tract Infections / Q000150:complications / Q000188:drug therapy*; D014555:Urination Disorders / Q000150:complications / Q000188:drug therapy*; D014563:Urodynamics
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin
keywords: dysfunctional voiding; recurrent urinary tract infection; uroflowmetry biofeedback; α1-blockers