Are female lower urinary tract symptoms alleviated by alpha-adrenoreceptor antagonists?

This commentary discusses the article by Low and colleagues, who studied the effect of terazosin in women with lower urinary tract symptoms (LUTS) and an International Prostate Symptom Score (IPSS) > o =8. Terazosin therapy significantly improved IPSS quality-of-life scores and King's Health Questionnaire scores. These findings might seem surprising, because previous studies have shown that alpha-adrenoreceptor antagonists are not effective in women with overactive bladder, which is considered the most common form of LUTS in females. Many women have voiding symptoms, however, and the inclusion criteria in this study resulted in a different population profile compared with those of other studies of female LUTS. The mechanism behind the effect of terazosin is unclear. Without urodynamic characterization, it cannot be established whether patients in the study were obstructed, or whether the effect of terazosin was related to a decrease in bladder outflow resistance.