PMID- 15871733
OWN - NLM
STAT- MEDLINE
DCOM- 20050606
LR  - 20220310
IS  - 1464-4096 (Print)
IS  - 1464-4096 (Linking)
VI  - 95 Suppl 4
DP  - 2005 Jun
TI  - Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest 
      update on alpha-adrenoceptor antagonists.
PG  - 29-36
AB  - An update of a systematic review of alpha1-adrenoceptor (AR) antagonists in the 
      treatment of lower urinary tract symptoms suggestive of benign prostatic 
      hyperplasia (LUTS/BPH) showed that these agents have comparable efficacy. The 
      total symptom score is improved by 30-45% and maximum urinary flow rate by 15-30% 
      vs baseline. alpha1-AR antagonists that can be started at their therapeutic dose 
      have a more rapid onset of action than alpha1-AR antagonists that have to be 
      titrated. alpha1-AR antagonists can be differentiated according to their 
      tolerability. Alfuzosin (especially the 10 mg once daily dose) and tamsulosin 
      (especially the 0.4 mg once daily dose) are better tolerated than doxazosin and 
      terazosin. However, alfuzosin might induce more cardiovascular adverse events 
      (AEs) in the elderly and/or patients with cardiovascular comorbidity and/or 
      comedication. Tamsulosin tends to interfere less with blood pressure regulation 
      and induce less vasodilatory AEs than alfuzosin, especially in the elderly, and 
      is well tolerated in patients with cardiovascular comorbidity and/or 
      comedication. Cardiovascular AEs might lead to potentially serious complications 
      such as falls, fractures and institutionalization. Abnormal ejaculation has 
      mainly been reported in placebo-controlled trials with tamsulosin but in direct 
      comparative trials its rate with tamsulosin 0.4 mg was similar to, or only 
      slightly higher than, the rate with alfuzosin. In addition, abnormal ejaculation 
      is not reported as bothersome by the patient or associated with serious 
      complications. It can be concluded that an alpha1-AR antagonist with a low 
      potential to interfere with blood pressure regulation and to induce 
      cardiovascular AEs, also in patients with cardiovascular comorbidity and/or 
      comedication, can be considered a first-choice treatment option in LUTS/BPH.
FAU - Milani, Shirin
AU  - Milani S
AD  - Department of Urology, University of Vienna, Vienna, Austria.
FAU - Djavan, Bob
AU  - Djavan B
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
RN  - 0 (Adrenergic alpha-Antagonists)
SB  - IM
CIN - BJU Int. 2006 Jan;97(1):198. PMID: 16336361
MH  - Adrenergic alpha-Antagonists/adverse effects/*therapeutic use
MH  - Blood Pressure/drug effects
MH  - Cardiovascular Diseases/chemically induced
MH  - Ejaculation/drug effects
MH  - Humans
MH  - Male
MH  - Prostatic Hyperplasia/*drug therapy
MH  - Treatment Outcome
RF  - 63
EDAT- 2005/05/06 09:00
MHDA- 2005/06/07 09:00
CRDT- 2005/05/06 09:00
PHST- 2005/05/06 09:00 [pubmed]
PHST- 2005/06/07 09:00 [medline]
PHST- 2005/05/06 09:00 [entrez]
AID - BJU5485 [pii]
AID - 10.1111/j.1464-410X.2005.05485.x [doi]
PST - ppublish
SO  - BJU Int. 2005 Jun;95 Suppl 4:29-36. doi: 10.1111/j.1464-410X.2005.05485.x.