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Urodynamic effect of acute alpha-receptor blockade in patients with bladder neck dysfunction
E U Poulsen1, H J Kirkeby, J C Djurhuus
1Department of Urology, Aarhus Municipal Hospital, Denmark.
Scandinavian Journal of Urology and Nephrology
|January 1, 1989
Summary
Phentolamine improved bladder emptying and peak flow rate in men with bladder neck dysfunction (BND). However, only a few patients showed significant improvement, suggesting its use in BND evaluation.
Area of Science:
- Urology
- Pharmacology
Background:
- Bladder neck dysfunction (BND) affects male micturition.
- Alpha-blockers are a potential treatment for BND.
Purpose of the Study:
- Evaluate acute alpha-blockade effects on micturition in BND patients.
- Identify patients who may benefit from alpha-blocking therapy.
Main Methods:
- 49 male patients with BND received intravenous phentolamine.
- Micturition parameters were assessed before and after phentolamine administration.
- Flow-rate nomogram analysis was used to assess peak flow rate improvement.
Main Results:
- Phentolamine significantly decreased maximal urethral closure pressure, bladder neck pressure, and prostatic profile length.
- Bladder capacity decreased, emptying improved, and peak flow rate showed a small but significant increase.
- Only two patients demonstrated significant peak flow rate improvement via nomogram analysis.
- Responders (20 patients) had longer opening times and lower maximal flow rates pre-treatment, indicating more severe BND.
Conclusions:
- Acute alpha-blockade with phentolamine improves some micturition parameters in BND patients.
- Predicting response to alpha-blockade prior to administration is not currently possible.
- Phentolamine administration may be a valuable diagnostic tool in evaluating suspected BND.