α1-Blockers Improve Benign Prostatic Obstruction in Men with Lower Urinary Tract Symptoms: A Systematic Review and Meta-analysis of Urodynamic Studies

European Urology
F FuscoVincenzo Mirone

Abstract

The urodynamic outcomes for α1-blockers (ABs) treatment in patients with lower urinary tract symptoms related to benign prostatic enlargement (LUTS/BPE) is a matter of debate. To perform a systematic review and meta-analysis of studies evaluating the ABs urodynamic outcomes in patients with LUTS/BPE. The primary endpoint was variation in bladder outlet obstruction index (BOOI). Secondary endpoints were the maximum urinary flow rate (Qmax) and detrusor pressure at Qmax (PdetQmax). A meta-analysis of placebo-controlled randomized clinical trials (RCTs) was performed to compare ABs with placebo. A systematic review of PubMed/Medline, ISI Web of Knowledge, and Scopus databases was performed in May 2015. Seventeen studies were selected for inclusion. The overall pooled data showed a mean BOOI change of -14.19 (p<0.0001), a mean PdetQmax change of -11. 39cm H2O (p<0.0001), and a mean Qmax improvement of 2.27ml/s (p<0.0001). Subgroup analysis showed a mean BOOI change of -14.88 (p=0.01) for alfuzosin, -19.41 (p=0.01) for doxazosin, -16.47 (p<0.0001) for naftopidil, -30.45 (p<0.0001) for silodosin, -14.27 (p=0.002) for tamsulosin, and -6.69 (p=0.005) for terazosin. Subanalysis of RCTs containing a placebo arm showed a significant impro...Continue Reading

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Citations

May 17, 2017·International Journal of Clinical Practice·Hyun Hwan SungKyu-Sung Lee
Nov 23, 2017·International Journal of Urology : Official Journal of the Japanese Urological Association·Yoshihisa MatsukawaMomokazu Gotoh
Aug 2, 2018·International Journal of Urology : Official Journal of the Japanese Urological Association·Koji IchiharaTakaoki Hirose
Oct 12, 2018·The Cochrane Database of Systematic Reviews·Eu Chang HwangPhilipp Dahm
Feb 23, 2019·Der Urologe. Ausg. A·M OelkeK Höfner
Jul 7, 2019·Neurourology and Urodynamics·Ruud BoschEskinder Solomon
Oct 2, 2019·Journal of Clinical Medicine·Yu-Hsiang LinKe-Hung Tsui
Jun 4, 2020·Therapeutic Advances in Urology·Pedro Abreu-MendesFrancisco Cruz
Jul 28, 2017·International Journal of Urology : Official Journal of the Japanese Urological Association·Yukio HommaKenji Maeda
Dec 14, 2018·Advances in Therapy·Luca VillaFrancesco Montorsi
Nov 22, 2017·The Cochrane Database of Systematic Reviews·Jae Hung JungPhilipp Dahm
Aug 4, 2020·Asian Journal of Urology·Renee E VickmanSimon W Hayward
Jan 1, 2021·Research and Reports in Urology·Gianluigi CalifanoFerdinando Fusco

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