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Can J Urol. 1998 Jun;5(2):551-557.
Alpha-blocker therapy for benign prostatic hyperplasia: a comparative review.

Goldenberg SL, Ramsey E, Trachtenberg J.

Associate Professor of Surgery (Urology), University of British Columbia, Vancouver, British Columbia.

In the past decade there has been a shift in the primary approach to therapy for BPH, from surgical intervention to pharmacotherapy. Therapies with alpha-blockers, particularly long-acting selective alpha1-adrenoreceptor antagonists, has proven effective, and hence has become a popular treatment option. In randomized controlled trials, 3 alpha-adrenoreceptor antagonists -terazosin, doxazosin, and tamsulosin -have been shown to significantly improve both the mean peak urinary flow and the severity of BPH-related symptoms. There are no currently published trials comparing the clinical efficacy of these drugs. Reports from non-comparative trials suggest that the effects on symptoms and flow rates are similar. However, side effects, such as postural hypotension, asthenia, and dizziness may be less with tamsulosin. Use of tamsulosin is associated with loss of ejaculation in 4.5% of men. Until differences in efficacy are demonstrated, the choice of alpha-blocker will depend on tolerance for side effects and convenience of administration.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11299113&dopt=Abstract [PubMed - as supplied by publisher]




J Nippon Med Sch. 2001 Apr;68(2):181-5.
The short-term effects of terazosin in Japanese men with benign prostatic hyperplasia.

Horiuchi K, Tsuboi N, Suzuki Y, Yoshida K, Akimoto M.

Department of Urology, Nippon Medical School, Tokyo, Japan.

We evaluated the short-term efficacy of terazosin for treating symptomatic benign prostatic hyperplasia (BPH). Thirty men, aged 52 to 83 years (mean: 69.2 years) complaining of obstructive urinary symptoms due to BPH who had not received any prior treatment for their symptoms were orally administered 2 mg/day of terazosin. Symptoms (the total IPSS and the obstructive and irritative symptom scores) and objective parameters (peak flow rate [Qmax] and prostatic volume) were evaluated before treatment and after 1, 2, and 4 weeks of treatment. The mean total IPSS and the mean symptom scores for weak stream and nocturia were significantly decreased after only 1 week of treatment, while the mean scores for emptying, frequency, and urgency were significantly decreased after 2 weeks of treatment. However, the mean scores for intermittency and hesitancy did not decrease significantly at any time during treatment. Regarding objective parameters, the mean Qmax was significantly improved after 1 week of treatment, but the mean prostatic volume remained almost unchanged after 4 weeks. In conclusion, short-term terazosin therapy not only improved Qmax but also alleviated symptoms including irritative symptoms.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11301364&dopt=Abstract




Can J Urol. 1998 Aug;5(3):578-584.
Combination medical therapy for symptomatic benign prostatic hyperplasia.

Savage SJ, Spungen AM, Galea G, Britanico J, Vapnek JM.

Department of Urology, The Mount Sinai School of Medicine, New York, New York.

PURPOSE: The purpose of this study was to evaluate treatment response to terazosin, finasteride, or a combination of both in men with symptomatic benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Patients with BPH were consecutively enrolled from a clinical urology practice. International Prostate Symptom Score (IPSS), peak urinary flow rate, and prostate volume were assessed at baseline and every 2 months for 12 months. Detrusor pressure at maximum flow was assessed at baseline, 4 and 12 months. Patients were randomized into 1 of 3 treatment groups - terazosin alone, finasteride alone, or combination therapy. RESULTS: At 12 months, symptom scores had decreased significantly in all 3 treatment groups (p<0.05). Combination therapy resulted in significantly greater reductions in IPSS than terazosin or finasteride (6.4, 4.9, 4.1 points, respectively, p<0.05) There were significant increases in peak urinary flow rate within each treatment group, although there were no significant changes between groups. Detrusor pressure also significantly decreased from baseline within each treatment group. Patients treated with combination therapy had a significantly greater mean decrease in detrusor pressure after 12 months when compared with finasteride-treated patients (16.7 versus 10.5 cm H20, p<0.03). There were no significant differences between terazosin and combination therapy or between terazosin and finasteride despite the relatively greater decrease in detrusor pressure seen in the terazosin group when compared with the finasteride group. CONCLUSIONS: Combination medical therapy with finasteride and terazosin provides greater symptom relief than monotherapy in men with BPH.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11305957&dopt=Abstract [PubMed - as supplied by publisher]





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