Clinical and urodynamic assessment of alpha-adrenolytic therapy in patients with neurogenic bladder function

The efficacy of alpha-adrenolytic treatment with oral phenoxybenzamine chloride (40 mg per day during three to four months) has been assessed both clinically and urodynamically among 249 patients with neurogenic bladder function. The results were significantly better in patients with autonomous (n = 95) than in the ones with automatic (n = 154) bladders (urethral sphincter spasticity and detrusor sphincter dyssynergia dominating the clinical picture in the latter event). A further striking difference was noticed when the data were analysed with regard to the patient's age, a far better therpeutic response being regularly recorded in subjects below age 35, while minimal and inconsistent improvements were observed in the older age group. No major side effects were encountered. Caution is however required in tetraplegics where phenoxybenzamine may aggravate orthostatic hypotension. On the other side the drug proves highly beneficial in these same patients in that it markedly lowers the incidence of dysreflexic states.