α1-Blockers Improve Benign Prostatic Obstruction in Men with Lower Urinary Tract Symptoms: A Systematic Review and Meta-analysis of Urodynamic Studies
| Autor: | Alessandro Palmieri, Nicola Longo, Giacomo Novara, Paolo Verze, Gianluca Giannarini, Vincenzo Mirone, Vincenzo Ficarra, Ferdinando Fusco, Massimiliano Creta |
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| Přispěvatelé: | Fusco, Ferdinando, Palmieri, Alessandro, Ficarra, Vincenzo, Giannarini, Gianluca, Novara, Giacomo, Longo, Nicola, Verze, Paolo, Creta, Massimiliano, Mirone, Vincenzo |
| Rok vydání: | 2015 |
| Předmět: |
Male
Indoles α1-Blocker Prostatic Hyperplasia 030232 urology & nephrology Benign prostatic hyperplasia Benign prostatic obstruction Bladder outlet obstruction index Lower urinary tract symptoms Meta-analysis Urodynamics α1-Blockers Adrenergic alpha-1 Receptor Antagonists Clinical Trials as Topic Doxazosin Humans Naphthalenes Piperazines Prazosin Prostatism Quinazolines Severity of Illness Index Sulfonamides Urology Urologic Surgical Procedure Terazosin 0302 clinical medicine Benign prostatic hyperplasia Benign prostatic obstruction Bladder outlet obstruction index Lower urinary tract symptoms Meta-analysis Urodynamics α1-Blockers Adrenergic alpha-1 Receptor Antagonists Clinical Trials as Topic Doxazosin Humans Indoles Male Naphthalenes Piperazines Prazosin Prostatism Quinazolines Severity of Illness Index Sulfonamides Urodynamics Urology Lower urinary tract symptom Alfuzosin Urinary Bladder Neck Obstruction 030220 oncology & carcinogenesis α1-Blockers Urologic Surgical Procedures Prostatic obstruction medicine.drug Tamsulosin medicine.medical_specialty MEDLINE Context (language use) 03 medical and health sciences Bladder outlet obstruction Text mining medicine Meta-analysi Gynecology business.industry Urinary bladder neck obstruction Urodynamic medicine.disease α1 blocker business |
| Zdroj: | European urology. 69(6) |
| ISSN: | 1873-7560 |
| Popis: | Context 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. Objective 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 ( Q max ) and detrusor pressure at Q max ( P det Q max ). A meta-analysis of placebo-controlled randomized clinical trials (RCTs) was performed to compare ABs with placebo. Evidence acquisition A systematic review of PubMed/Medline, ISI Web of Knowledge, and Scopus databases was performed in May 2015. Seventeen studies were selected for inclusion. Evidence synthesis The overall pooled data showed a mean BOOI change of –14.19 ( p P det Q max change of –11. 39cm H 2 O ( p Q max improvement of 2.27ml/s ( p p =0.01) for alfuzosin, –19.41 ( p =0.01) for doxazosin, –16.47 ( p p p =0.002) for tamsulosin, and –6.69 ( p =0.005) for terazosin. Subanalysis of RCTs containing a placebo arm showed a significant improvement in BOOI in patients undergoing ABs treatment. Meta-regression revealed a significant positive association between the percentage of patients with obstruction at baseline and the improvement in BOOI after treatment with ABs. Conclusion ABs improve BOOI in patients with LUTS/BPE mainly by reducing P det Q max , and this effect is higher in patients presenting with urodynamic obstruction at baseline. The free Q max variation underestimates the real effect of ABs on benign prostatic obstruction. Patient summary Results of this meta-analysis suggest that α1-blockers objectively improve urinary voiding function in patients with benign prostatic obstruction. |
| Databáze: | OpenAIRE |
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