Effectiveness of Baclofen Plus Terazosin treatment in Patients with Lower Urinary Tract Symptoms Caused by Spastic Urethral Sphincter

Abstract

Objective: To compare the effectiveness of treatment with baclofen alone or baclofen combined with terazosin in patients with spastic urethral sphincter. Materials and Methods: In a consecutive series of 580 patients with lower urinary tract symptoms (LUTS), spastic urethral sphincter was diagnosed as the cause of voiding symptoms in 137 patients (61 men and 76 women). These 137 patients were treated with baclofen 10mg t.i.d alone or in combination with treazosin 2 mg q.d. for at least 3 months. Baseline and post-treatment international prostate symptom score (IPSS), maximal flow rate (Qmax), and residual urine amount were assessed and compared. Results: Among the 137 patients, improvement in both IPSS and Qmax at the end of 3 months was found in 68 (49.6%), and in IPSS alone in 25 (18.2%). The total success rate was 67.9%. There was no significant difference in the total success rate between men (67.2%) and women (68.5%). However, a significantly higher success rate was found in the patients treated with combined baclofen and terazosin (82.8%) compared to those treated with baclofen alone (52.7%). Conclusions: In this series, spastic urethral sphincter was the most common cause of LUTS in non-obstructive men (54.5%) and was also highly prevalent in women with frequency urgency syndrome (29.7%). Treatment of spastic urethral sphincter disease with combined baclofen and terazosin is effective and has a higher success rate than baclofen alone in both men and women.