Evaluation of the efficacy and safety of α1 adrenergic blockers for treating young men with primary bladder outlet obstruction

Abstract

Objective To evaluate the efficacy and safety of α1-adrenergic blockers for treating young men with primary bladder neck obstruction (PBNO). Methods A retrospective review was done of the presenting symptoms and videourodynamic findings of 22 young men younger than 35 years with PBNO. Mean age was 28 years (range 18 to 35). The presenting symptoms were hesitancy in 21 (95%), weak stream in 17(77%), frequency in 16(73%), urgency in 8(36%) and pelvic pain in 6 (27%). Mean symptom duration was 28(3-62)months. A dose of 4 mg Doxazosion was adminis-tered for at least 6 months. International prostate symptom score(IPSS), Quality of life(QOL), uro-flowmetry, post-void residual urine and blood pressure were assessed before and 6 months after medi-cation. Improved urine flow was defined as at least 3 ml. per second increase in the maximum flow rate. Improved symptom was defined as more than a 40% decrease in IPSS. Successful treatment was defined as improved in urine flow and symptoms. Results Follow-up data were available for 21 of 22 patients. The medication period was 8.7±2.5 months and follow-up duration was 12.3±4.9 months. Mean Ⅰ-PSS decreased from 16.9±3.7 to 10.7±4.5. Mean QOL decreased from 4.3±1.2 to 2.5±1.0. Mean maximum flow rate increased from (9.8±3.5)ml to (14.9±3.6)ml. per second. Mean post-void residual urine decreased from (78.2±35.6)ml to (46.5±19.4)ml. There were significant differences(P 0.05). Conclusions Videourody-namics is the diagnostic gold standard of PBNO. In our experience α1-adrenergic blockers are clinically effective therapy and safety for PBNO and have been well tolerated in young male patients. Key words: Bladder outlet obstruction; α_1-adrenergic blockers