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[Doksazozin "Cardura" in acute urinary retention caused by benign prostatic hyperplasia]
Insights
Doxazosin, an alpha 1-adrenoblocker, effectively treats acute ischuria (AI) caused by benign prostatic hyperplasia (BPH), restoring spontaneous urination in over half of patients. This drug offers a valuable therapeutic option for BPH-related urinary retention.
Area of Science:
- Urology
- Pharmacology
Background:
- Acute ischuria (AI) in benign prostatic hyperplasia (BPH) is primarily managed with bladder catheterization.
- AI stems from anatomical obstruction, detrusor energy imbalance, and smooth muscle hypertonia.
- Alpha 1-adrenoreceptor activity contributes to the dynamic obstruction component in BPH.
Purpose of the Study:
- To evaluate the efficacy of the alpha 1-adrenoblocker doxazosin in treating AI caused by BPH.
- To compare doxazosin's effectiveness against placebo in restoring spontaneous urination.
Main Methods:
- A prospective, randomized, placebo-controlled study involving 36 BPH patients with AI.
- Patients received either doxazosin or placebo after initial bladder catheterization and a 12-hour randomization period.
Main Results:
- Spontaneous urination was restored in 55.5% of all patients.
- Doxazosin led to restoration in 63.3% of patients, compared to 16.6% in the placebo group.
- 37.9% of doxazosin-treated patients were discharged for outpatient alpha-blocker therapy, avoiding immediate surgery.
Conclusions:
- Doxazosin significantly increases the likelihood of spontaneous urination recovery in AI patients with BPH.
- Doxazosin provides a therapeutic window for surgical preparation and potential outpatient management.
- Further investigation into long-term alpha-blocker therapy post-AI resolution in BPH is warranted.
Abstract:
Drug treatment of acute ischuria (AI) caused by benign prostatic hyperplasia (BPH) is discussed. Catheterization of the urinary bladder is the main treatment for AI. AI is caused by anatomical obstruction, hypertone of smooth myocytes, and energy imbalance of detrusor. Use of alpha 1-adrenoblockers in AI is pathogenetically justified, as the development of stable spasm of smooth-muscle structures of the prostate, vesical cervix, and prostatic compartment of the urethra resultant from increased functional activity of alpha 1-adrenoreceptors underlies the dynamic component of obstruction. alpha 1-Adrenoblocker doxazosin (cardura) was used for arresting AI caused by BPH after 12-h randomization and catheterization of the bladder. A prospective randomized placebo-controlled study was carried out on 36 patients. Spontaneous urination was restored in 55.5% patients, in 63.3% of these after doxazosin and in 16.6% after placebo. 37.9% of patients from the doxazosin group were discharged from hospital for outpatient therapy with alpha-blockers and the rest were operated on. Hence, doxazosin increases the chance of recovery of spontaneous urination for patients with AI caused by BPH and allows time and conditions for preparation of patients to surgery. Therapy with alpha 1-adrenoblockers after resolution of AI in patients with BPH can be effective and should be further investigated.