Alpha blockers help improve LUTS, QoL in patients with benign prostatic hyperplasia
Use of alpha blockers, including silodosin, tamsulosin and alfuzosin, in the treatment of patients with benign prostatic hyperplasia (BPH) is safe and effective in terms of improving lower urinary tract symptoms (LUTS) and quality of life (QoL), according to a study.
The study included 364 sexually active men (mean age 54.8 years) with moderate to severe LUTS. None of the patients had a history of prostate surgery, suspicious digital rectal examination findings, serum prostate-specific antigen (PSA) >4 ng/dl and history of medication with anticholinergic/cholinergic /diuretic agents.
Participants were stratified by prescription of once-daily oral silodosin 8 mg, tamsulosin 0.4 mg or alfuzosin 10 mg. Assessments were performed at weeks 4 and 12 to examine the treatment effects on erectile function and seminal vesicles dimensions.
Baseline erectile function score (International Index of Erectile Function, IIEF-EF) was 26.4 in the silodosin group, 27.6 in the tamsulosin group and 28.1 in the alfuzosin group. The baseline overall satisfaction (IIEF-OS) was 7.1, 8.3 and 8.6, respectively.
After 12 weeks of treatment, the alpha blockers yielded significant improvements in total International Prostate Symptom Score (IPSS) and QoL scores. (p<0.001). IIEF-EF score dropped to 24.0 in the silodosin group, 24.7 in the tamsulosin group and 26.2 in the alfuzosin group. IIEF-OS was 6.4, 7.8 and 7.9, respectively.
All three treatment groups showed statistically significant improvement in seminal vesicles at week 12, with the magnitude of effect greater with silodosin (7.65 to 14.11 cc; p<0.001).
There were no reports of major side effects occurring across the three groups, with the exception of anejaculation, which was largely associated with the use of silodosin.
Researchers noted the absence of any correlation between sexual function and seminal vesicles enlargement. Moreover, enlargement of seminal vesicles with alpha blockers failed to show clinical significance.
More studies are needed to determine the exact mechanism of the present findings, researchers added.