Postvoid residual urine in patients with lower urinary tract symptoms succestive of benign prostatic hyperplasia: Pooled analysis of eleven controlled studies with alfuzosin

Objectives. A pooled analysis was conducted in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia to examine the re lationship between the postvoid residual urine (PVR) volume and various cli nical characteristics and to assess the effect of alfuzosin, a clinically u roselective alpha,blocker, on PVR volume and any other associated outcome. Methods. Nine hundred fifty-three patients, 42 to 89 years old, with a base line PVR volume between 50 and 350 mL (mean 106 mL) were enrolled in 11 dou ble-blind controlled studies and received either alfuzosin (n = 607) or pla cebo (n = 346) for 1 to 6 months. The relationships between the baseline PV R volume measured by transabdominal ultrasound and age, symptoms, maximum f low rate (Qmax), estimated bladder capacity, and prostate-specific antigen level were assessed. The changes in the PVR volume with treatment were eval uated in all available patients at three endpoints (1, 3, and 6 months). Results. At baseline, a PVR volume of 100 mL or greater was observed in 60% , 47%, and 39% of patients with a Qmax less than 8, 8 to 11, and greater th an 1 mL/s, respectively (P = 0.001). The bladder capacity was also signific antly related to the Qmax (P = 0.0001). No relationship was found between P VR volume and age, symptoms. or prostate-specific antigen level. The change s in the PVR volume with treatment were related to the baseline PVR volume. However, at all endpoints and whatever the baseline PVR volume, the decrea ses in the PVR volume were significantly (P < 0.01) greater with alfuzosin than with placebo. Acute urinary retention occurred in 7 patients (2 [0.3%] of 607 patients taking alfuzosin and 5 [1.4%] of 346 patients taking place bo); 6 of these 7 patients had a baseline PVR volume greater than 100 mL. Conclusions. In this population of men with lower urinary tract symptoms su ggestive of benign prostatic hyperplasia, the PVR volume and bladder capaci ty were related to the baseline Qmax. Alfuzosin significantly reduced the P VR volume compared with placebo, and this effect was more marked in patient s with a high PVR volume at baseline. Acute urinary retention occurred main ly in patients with a PVR volume greater than 100 mL and was less frequent in patients taking alfuzosin than in those taking placebo. UROLOGY 57: 459- 465, 2001. (C) 2001, Elsevier Science Inc.