Perioperative alpha blockers in voiding dysfunction secondary to prostate biopsy: A meta-analysis

Area of Science:

• Urology
• Pharmacology

Background:

• Voiding dysfunction is a common complication following prostate biopsy, impacting patient morbidity.
• Alpha blockers are increasingly used to prevent these side effects, but evidence of efficacy is limited.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of perioperative alpha blockers in improving post-prostate biopsy voiding function.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, Embase, PubMed) from 1989 to 2023.
• Six randomized controlled trials involving 808 patients were included, comparing alpha blockers to controls.
• Data on International Prostate Symptom Scores (IPSS), Qmax, postvoid residuals (PVR), acute urinary retention (AUR), and quality of life (QoL) were extracted for meta-analysis.

Main Results:

• Alpha blocker use showed statistically significant improvements in IPSS, PVR, Qmax, and QoL scores.
• The overall risk of acute urinary retention (AUR) was significantly reduced in the alpha blocker group (OR 0.22, CI 0.09-0.55, p=0.001).
• Heterogeneity varied across outcomes (I² = 0-86%).

Conclusions:

• Perioperative alpha blockers demonstrate a potential role in enhancing urinary function post-prostate biopsy.
• Routine incorporation of alpha blockers may be considered to reduce the morbidity associated with voiding complications after prostate biopsy.