ALPHA-BLOCKADE IN THE TREATMENT OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA

Purpose: The clinical and urodynamic effects of oral alpha 1-selective adrenoceptor blockers in the treatment of symptomatic benign prostati c hyperplasia were quantified, and side effects and patient tolerance were assessed. Materials and Methods: A total of 29 original reports o f placebo controlled clinical trials of alpha-blockers in which result s were adequately presented was identified and reviewed, along with ad ditional pertinent literature. We assumed that the efficacy of the dif ferent alpha-blockers was basically the same and the weighted average treatment effect was calculated in comparison with placebo. Results: T he average improvement in maximum urine flow rate was 1.5 ml. per seco nd but this rate would probably approach 1.8 to 1.9 ml. per second if all dosages had been titrated up to the highest level tolerated. Overa ll symptom score decreased by 14% and residual urine volume decreased by 29%. A slight decrease in detrusor pressure during voiding was sugg ested. Conclusions: alpha-Blockers were beneficial in the treatment of benign prostatic hyperplasia. Tolerance to treatment appeared to deve lop in a large proportion of patients after 6 months of therapy. Howev er, for patients who benefit from long-term use of alpha-blockers effe ctive treatment might be maintained for years.