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Alpha blockade for BPH


Clinical bottom line

Alpha blockers improved urinary flow rate and symptoms more than placebo in the short term.


LM ERi & KJ Tveter. Alpha-blockade in the treatment of symptomatic benign prostatic hyperplasia. Journal of Urology 1995 154: 923-934.


The search used MEDLINE to January 1995, plus conference abstracts, to identify 29 reports (five abstracts) of alpha1-adrenergic blockers in men with symptoms of BPH. These were randomised and placebo-controlled. No trial quality of validity assessment was made. Some studies were open-label. Details of urinary flow rates at inclusion are given.


There was information on 1,990 men receiving alpha blockers out of a total of 3,464 men. A table gives details of individual drugs, and doses, and treatment duration (usually short with a median of four weeks of therapy), and change in mean maximum flow rate and symptoms.

The mean weighted change in flow rate with alpha blockers was 2.3 mL/second for alpha blockers and 0.8 mL/second for placebo, a 16% difference.

The weighted average improvement in symptom score was 39% for alpha blockers and 25% for placebo, a difference of 14%.

The effect of dose was discussed, but no pooled information was given by drug, by dose, or by duration of treatment.


A useful if limited review.