Comparing the therapeutic outcome of different alpha-blocker treatments for BPH in the same individuals

Abstract

Alpha-blockers are the most widely used agents to treat lower urinary tract symptoms in males, and switching between alpha-blockers is a frequent management option when the desired effect could not be obtained. There is no data in the literature that reveal the outcome of treatments with different alpha-blockers within the same patient. We sought the answer to this question in a setting where the same individuals were treated with two different agents during different time frames. Forty males with benign prostatic hyperplasia (BPH) applying to the Department of Urology with lower urinary tract symptoms (LUTS) were enrolled in the study consecutively. Patients were evaluated with detailed medical history, IPSS forms, digital rectal examination (DRE), urinary ultrasound, PSA, and uroflowmetry. The subjects received terazosin 5 mg daily for 3 months, and controlled release form of alfuzosin 10 mg daily for another 3 months, leaving a 1-month clearance period in between. The above-mentioned detailed evaluations were carried out before and after each alpha-blocker regimen. Mean age and PSA level was 63.3+/-1.6 years (45-80), and 2.1+/-0.4 ng/ml (0.16-6.3 ng/ml). IPSS and Qmax values before treatment with terazosin and alfuzosin were similar. Improvements in IPSS and Qmax values after treatments with both terazosin and alfuzosin were significant. There was no statistically significant difference between the drugs in terms of percent improvements in IPSS and Qmax with alpha-blocker treatment. No untoward effect except for transient dizziness in one case with terazosin treatment was encountered. Different alpha-blockers, which are used during different time frames in the same individuals, provide similar efficiency outcome. When the desired effect in the treatment for BPH could not be obtained with one alpha-blocker, there may not be any benefit in switching to another one.