The efficacy of alfuzosin treatment in patients with prostatism

Alfuzosin, a quinazoline derivative, is a selective alpha-la adreneceptor antagonist with further selectivity for the alpha-1 adrenoceptors of the lower urinary tract and lesser affinity for vascular alpha-1 adrenoceptors. The present study evaluates the efficacy of alfuzosin in a group of the patients with prostatism.

Eighty-two patients with lower urinary tract symptoms aged from 55 to 76 years (mean age 62.36 +/- 6.4) were enrolled in the study. The patients were evaluated by blood pressure measurement, digital rectal examination, serum total and free prostate specific antigen (PSA) determinations by Tandem R-Assay with the reference range of 0.0 to 4.0 ng/ml, international prostate symptom score (IPSS), volume measurement by transrectal prostate ultrasound, blood biochemistry, uroflowmetry, postvoiding residual urine (PVRU) assessment. The patients treated with alfuzosin 2.5 mg three times a day for 3 months were re-evaluated by blood pressure measurement, IPSS, urine flow rate (UFR) and PVRU assessment in the 2nd week and in the 6th week, and by blood pressure measurement, IPSS, blood biochemistry, serum total and free PSA determinations, UFR and PVRU assessment in the 3rd month. Statistical analysis was performed using student-t test, and p value was considered significant when less than 0.05.

Although IPSS significantly decreased in the 2nd week of the treatment compared to pre-treatment value, it reached a maximum decrease in the 6th week of the treatment. There were statistically significant difference between in the 2nd week IPSS value and the 6th week IPSS value. However, no difference was seen between the 6th week IPSS value and the 3rd month IPSS value. No significant difference was observed between pre-treatment values and the 2nd week values regarding UFR and PVRU. Peak flow rate and PVRU significantly changed in the 6th week of the treatment and they reached maximum change in the 3rd month. Difference was also significant between the values in the 6th week of the treatment and those in the 3rd month of the treatment. According to the blood biochemical analysis, total and free PSA levels before and after the treatment, there were no significantly difference. Additionally, alfuzosin had no effect on blood pressure. Before, during and after the treatment, blood pressure did not change significantly.

Present study showed that symptomatic improvement with alfuzosin treatment began in the 2nd week, reaching the maximum level in the 6th week whereas urodynamic parameters began to improve in the 6th week and reached the maximum level in the 3rd month with no effect on blood pressure and blood biochemical test.