A comparison of four different alpha1-blockers in benign prostatic hyperplasia patients with and without diabetes

The aim of this study was to evaluate the intensity of lower urinary tract symptoms in patients with benign prostatic hyperplasia (BPH) with and without diabetes. We also determined whether alpha1-blockers improve subjective and objective symptoms similarly in these patients.

The study subjects comprised 281 patients (60 with diabetes and 221 non-diabetics with clinically diagnosed BPH) who were treated with alpha1-blockers (doxazosin, terazosin, alfuzosin and tamsulosin). The international prostate symptom score (IPSS), bother score, maximum flow rate (Q(max)) and post-void residual urine volume (PVR) were determined at baseline and after treatment for a minimum of 6 months.

Diabetic patients had a lower baseline Q(max) than non-diabetics (p < 0.001), while the IPSS, bother score and PVR did not differ significantly between the two groups. After treatment with alpha1-blockers, lower urinary tract symptoms improved significantly. The improvement rates of the IPSS and bother score were significantly higher in the diabetic patients than in the non-diabetics (p < 0.01). The relationship between the duration of diabetes and the effect of alpha1-blockers on IPSS, bother score, Q(max) and PVR was not statistically significant (p > 0.05).

The voiding function of the bladder may be more affected by diabetes than the storage function in patients with BPH. Treatment with alpha1-blockers appears to be useful for diabetic patients with BPH and its effectiveness is not altered by the duration of diabetes.