alpha-blockade improves symptoms suggestive of bladder outlet obstruction but fails to relieve it

Purpose: We investigated the effect of the alpha -blockers alfuzosin, teraz osin and tamsulosin on urodynamic parameters after 6 months of therapy. Materials and Methods: Between February 1992 and June 1998, 163 patients wi th lower urinary tract symptoms suggestive of bladder outlet obstruction we re treated with alfuzosin (60), terazosin (66) and tamsulosin (37). Patient s were evaluated with urodynamic studies, including pressure flow analysis, before treatment and after 6 months of therapy. Initially, all patients we re also assessed by the International Prostate Symptom Score questionnaire and measurement of urinary flow rate. Results: The majority of patients had no clear improvement in obstructive p arameters, regardless of the alpha -blocker used, as urethral resistance fa ctor and detrusor pressure maximum flow rate decreased by only 4 cm. H2O. T here was a clear subjective and statistically significant decrease in Inter national Prostate Symptom Score and quality of life scores of 6 and 2 point s, respectively. No relevant statistical difference was noted among the eff ects of the 3 alpha -blockers on relieving symptoms or improving urodynamic parameters of obstruction. Conclusions: The alpha -blockers are effective for treating symptoms sugges tive of bladder outlet obstruction in patients presenting with lower urinar y tract symptoms but not for treating the obstruction.