EFFECT OF TERAZOSIN ON URINE STORAGE AND VOIDING IN THE AGING MALE WITH PROSTATISM

Patients in a private practice, evaluated for prostatism due to benign prostatic hypertrophy were offered the options of medical treatment w ith the alpha blocker terazosin, surgical treatment, or continued obse rvation. Nineteen men accepted terazosin treatment and are the subject s of the present series. They were treated over a mean period of 8 mon ths, the longest treatment lasting over 22 months. Dosage was started at 1 mg/d and increased as tolerated to 2, 5, and 10 mg/d over the tes t period. Extensive testing including invasive urodynamics, multiple v oiding diaries, and symptoms scores at each dosage level was carried o ut. We found that flow rates increased moderately from baseline in a d ose dependent fashion. At the 10 mg/d dosage some patients achieved fl ow rates in the low normal range. Patients on treatment documented a d ecrease in the number of voidings per day, a decrease in nocturia, an increase in bladder capacity and the volume of each voiding. On the ot her hand, patients frequently did not appreciate changes in their void ing patterns, as reflected in their responses to the symptom questionn aires. We could not demonstrate significant changes in bladder pressur es on cystometry either during filling or voiding. Our data suggested that terazosin may well have a direct effect on the fundus of the agin g bladder to increase capacity, and, through the well-known relationsh ip between voided volume and flow rate, increase urinary flow rate. (C ) 1994 Wiley-Liss, Inc.