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Prostate Cancer Prostatic Dis. 1999 Dec;2(S4):S9-S15.

alpha(1)-Blocker therapy in the nineties: focus on the disease.

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  • 1Department of Urology, Hannover Medical School, Hannover, Germany.

Abstract

Therapy for benign prostatic hyperplasia has evolved rapidly over the last decade, with the introduction in the early 1990s of new agents such as alpha(1)-blockers and 5alpha-reductase inhibitors. The major advantage of alpha(1)-blockers over 5alpha-reductase inhibitors is their rapid onset of action. Maximum flow rate is improved after first administration and optimal symptom relief is usually reached within 2-3 months. In addition, alpha(1)-blockers are effective regardless of prostate size and they provide a similar degree of symptom relief in patients with or without bladder outlet obstruction. The main adverse events with the alpha(1)-blockers relate to their effects on the cardiovascular system (postural hypotension) and central penetration (asthenia, somnolence). Newer uroselective alpha(1)-blockers, such as alfuzosin and tamsulosin, have a better safety profile and, as such, do not require initial dose titration. Alfuzosin has also been shown in a six-month study to significantly reduce both residual urine and the incidence of acute urinary retention (AUR) compared with placebo. In addition, alfuzosin is effective in improving the success rate of a trial without catheter in patients with AUR.

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