EFFECT OF INTRAVENOUS ALFUZOSIN ON URETHRAL PRESSURE IN PATIENTS WITHNEUROGENIC BLADDER DYSFUNCTION

In order to assess the ability of a single intravenous (IV) injection of alfuzosin, a selective alpha-1 blocker, in reducing high urethral t one in patients with symptomatic neurogenic bladder dysfunction (NBD), 163 patients (mean maximal urethral pressure [MUP] 108 +/- 46 cm H2O) were enrolled in a double-blind, placebo-controlled, parallel-group t rial and were randomly allocated to receive 0.5 mg (n = 45), 1 mg (n = 41), 2 mg (n = 39) alfuzosin or placebo (n = 38). The decrease in MUP was dose-dependent and statistically significant (P less than or equa l to 0.05) for 1 and 2 mg alfuzosin (respectively, 43 +/- 28 cm H2O an d 46 +/- 27 cm H2O decreases vs. baseline) in comparison with placebo (23 +/- 30 cm H2O). The 2 mg dose level was the most effective leading to a greater than or equal to 30 or 50% decrease in MUP in, respectiv ely, 69 and 44% of patients. The safety of all three alfuzosin dose le vels was satisfactory and comparable to placebo. IV alfuzosin induces, in a dose-related manner, a clinically significant decrease in urethr al pressure in patients with NBD and high urethral tone, and may be sa fely used asa pharmacological test as part of an urodynamic investigat ion. (C) 1996 Wiley-Liss, Inc.