Int Neurourol J.  2018 Mar;22(1):30-40. 10.5213/inj.1834904.452.

Efficacy of an Alpha-Blocker for the Treatment of Nonneurogenic Voiding Dysfunction in Women: An 8-Week, Randomized, Double-Blind, Placebo-Controlled Trial

Affiliations
  • 1Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 2Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ksleedr@skku.edu
  • 3Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Urology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.
  • 5Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
  • 6Department of Urology, Cheil General Hospital & Women's Heathcare Center, Dankook University College of Medicine, Seoul, Korea.
  • 7Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
  • 8Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 9Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 10Department of Urology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.

Abstract

PURPOSE
To evaluate the efficacy of an alpha-1 adrenergic receptor (α1-AR) blocker for the treatment of female voiding dysfunction (FVD) through a pressure-flow study.
METHODS
This was a randomized, double-blind, placebo-controlled trial. Women aged ≥18 years with voiding symptoms, as defined by an American Urological Association symptom score (AUA-SS) ≥15 and a maximum flow rate (Qmax) < 15 mL/sec with a voided volume of >100 mL and/or a postvoid residual (PVR) volume >150 mL, were randomly allocated to either the alfuzosin or placebo group. After 8 weeks of treatment, changes in the AUA-SS, Bristol female lower urinary tract symptoms (BFLUTS) questionnaire, Qmax/PVR, and voiding diary were compared between groups. Patients' satisfaction with the treatment was compared. Patients were categorized into 3 groups according to the Blaivas-Groutz bladder outlet obstruction (BOO) nomogram: none, mild, and moderate to severe. Subgroup comparisons were also made.
RESULTS
Of a total of 187 women, 154 (79 alfuzosin, 75 placebo) were included in the analysis. After 8 weeks of treatment, the AUA-SS decreased by 7.0 in the alfuzosin group and by 8.0 in the placebo group. Changes in AUA-SS subscores, BFLUTS (except the I-sum), the voiding diary, and Qmax/PVR were not significantly different between groups. Approximately 54% of the alfuzosin group and 62% of the placebo group were satisfied with the treatment. No significant difference was observed between groups according to the presence or grade of BOO.
CONCLUSIONS
Alfuzosin might not be more effective than placebo for treating FVD. The presence or the grade of BOO did not affect the results. A further study with sufficient power is needed to determine the efficacy of α1-AR blockers for the treatment of FVD.

Keyword

Adrenergic alpha-antagonists; Bladder outlet obstruction; Female; Urodynamics

MeSH Terms

Adrenergic alpha-Antagonists
Female
Humans
Lower Urinary Tract Symptoms
Nomograms
Receptors, Adrenergic, alpha-1
Urinary Bladder Neck Obstruction
Urodynamics
Adrenergic alpha-Antagonists
Receptors, Adrenergic, alpha-1
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