Clinical and Pressure-Flow Changes after Long-Term Treatment with Alfuzosin SR

Abstract

Objectives: The aim of our study was to evaluate the symptomatic and urodynamic changes after 1–5 years of treatment with alfuzosin in patients with benign prostatic hyperplasia. Methods: Out of 255 patients with lower urinary tract symptoms observed from 1992 to 1997, who completed the International Prostatic Symptom Score (I-PSS) and underwent full urodynamic investigation, 161 were found to be obstructed (Schäfer classes 2–6). One hundred and two subsequently consented to a second clinical and urodynamic evaluation. Out of these, 46 underwent surgical treatment, 20 were elected for watchful waiting (WW) and 36 received a medical treatment. Twenty out of these, with a mean age of 65 years, a mean prostatic volume of 44 ml (20–70) a median Schäfer’s obstruction class of 3 (range 2–5) were treated with slow release alfuzosin 5 mg twice a day. We re-evaluated these 20 patients with a second I-PSS and pressure-flow study after 1–5 years (mean: 2 years) of treatment. The patients in the WW group with comparable baseline characteristics were considered as controls. The Wilcoxon matched-pairs signed rank test and the Kruskal-Wallis test were used for statistical analysis. Results: In the group treated with alfuzosin, no differences were noted for I-PSS (14.9 ± 6,8; 13.3 ± 5); maximum flow (124 ± 6; 14 ± 6) and projected isometric pressure (105 ± 36; 105 ± 26). Statistically significant differences were noted for residual urine (103 ± 100; 33 ± 38, p = 0.02); detrusor pressure at maximum flow (64.4 ± 23; 53 ± 12, p = 0.04), minimum urethral opening pressure (36.5 ± 9; 31 ± 9, p = 0.02), Schäfer class (2.7 ± 0.7; 2 ± 0.8, p = 0.04); urethral resistance algorithm (34.7 ± 11; 27 ± 7, p = 0.02). Statistically significant differences between baseline and follow-up were noted for none of the clinical and urodynamic parameters in the WW group. Conclusions: Patients with bladder outlet obstruction seem to remain clinically stable and to improve urodynamically when treated with alfuzosin for a long period of time.