Efficacy of doxazosin in the treatment of acute urinary retention due to benign prostate hyperplasia.

OBJECTIVE

To evaluate the efficacy of modified-release doxazosin 4 mg in the treatment of patients with acute urinary retention (AUR) due to benign prostate gland hyperplasia (BPH). An evaluation is made of the number of patients recovering spontaneous micturition after catheter removal, micturition quality, and the number of patients suffering new AUR episodes or who require surgery in the 2 years following the first episode.

PATIENTS AND METHODS

A randomized, controlled study in males with AUR secondary to BPH. Two groups are formed, administering modified-release doxazosin 4 mg to patients born in even-numbered years, once a day in the morning. Those born in odd-numbered years receive no medication. The catheter is withdrawn 1 month later. Flowmetry is performed, with determination of ultrasonographic postmicturition retention at withdrawal, and after 6, 12 and 24 months.

RESULTS

Of the 65 patients included, 47 proved evaluable, and 46 complied with treatment (with exclusion of 1 case due to hypotension). Of the 22 patients treated with doxazosin, 15 (68.86%) presented AUR after 2 years, while 7 (31.2%) showed spontaneous micturition. Of the 24 patients treated with bladder catheterization in the absence of medication, 16 (66.6%) presented AUR after the same period of time, while 8 (33.3%) showed spontaneous micturition. There were no statistically significant differences between the treated and untreated subjects in terms of drug efficacy. Residual flow parameters are described in the population with spontaneous micturition in each stage of the study.

CONCLUSION

In our series, treatment with the alpha-blocker doxazosin (4 mg, modified-release formulation), added to bladder catheterization, showed no increased efficacy in AUR treatment versus catheterization alone. Two years after the urinary retention episode, 31.2% of the patients treated with modified-release doxazosin 4 mg, and 33.3% of those with a bladder catheter only were seen to maintain spontaneous micturition.