Randomized crossover comparison of tamsulosin and alfuzosin in patients with urinary disturbances caused by benign prostatic hyperplasia.

PURPOSE

The aim of this study was to compare the efficacy and safety of alfuzosin (Alf) and tamsulosin (Tam) in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

One hundred men with benign prostatic hyperplasia (BPH) who were admitted to our urology department with lower urinary tract symptoms (LUTS) were enrolled in this randomized cross-over study. At enrollment, detailed medical history was recorded, and International Prostate Symptom Score (IPSS), digital rectal examination, urinary ultrasound, prostate specific antigen (PSA) level, and uroflowmetry were determined. BPH patients with IPSS greater than 8 and maximum urinary flow rate (Q(max)) lower than 15 ml/s were randomly divided into a Alf-Tam group (Alf for 8 weeks, followed by Tam for 8 weeks) or a Tam-Alf group (Tam for 8 weeks, followed by Alf for 8 weeks). There was no withdrawal period (washout) when switching drugs.

RESULTS

In the first treatment period, each drug significantly improved IPSS and Q(max). In both the Alf-Tam and Tam-Alf groups, cross-over was effective in improving IPSS and Q(max). Alf and Tam significantly lowered IPSS and significantly increased Q(max) from baseline (P < 0.001). Neither drug affected serum PSA levels.

CONCLUSIONS

Tam and Alf, which were used during different time frames in the same individuals, are associated with similarly favorable outcomes. When one alpha-blocker does not provide a desired effect in the treatment of BPH, switching to another alpha-blocker seems to be beneficial.