Efficacy of an Alpha-Blocker for the Treatment of Nonneurogenic Voiding Dysfunction in Women: An 8-Week, Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

Purpose To evaluate the efficacy of an alpha-1 adrenergic receptor (alpha 1-AR) blocker for the treatment of female voiding dysfunction (FVD) through a pressure-flow study. Methods This was a randomized, double-blind, placebo-controlled trial. Women aged >= 18 years with voiding symptoms, as defined by an American Urological Association symptom score (AUA-SS) >= 15 and a maximum flow rate (Qmax) < 15 mL/sec with a voided volume of > 100 mL and/or a postvoid residual (PVR) volume > 150 mL, were randomly allocated to either the alfuzosin or placebo group. After 8 weeks of treatment, changes in the AUA-SS, Bristol female lower urinary tract symptoms (BFLUTS) questionnaire, Qmax/PVR, and voiding diary were compared between groups. Patients' satisfaction with the treatment was compared. Patients were categorized into 3 groups according to the Blaivas-Groutz bladder outlet obstruction (BOO) nomogram: none, mild, and moderate to severe. Subgroup comparisons were also made. Results Of a total of 187 women, 154 (79 alfuzosin, 75 placebo) were included in the analysis. After 8 weeks of treatment, the AUA-SS decreased by 7.0 in the alfuzosin group and by 8.0 in the placebo group. Changes in AUA-SS subscores, BFLUTS (except the I-sum), the voiding diary, and Qmax/PVR were not significantly different between groups. Approximately 54% of the alfuzosin group and 62% of the placebo group were satisfied with the treatment. No significant difference was observed between groups according to the presence or grade of BOO. Conclusions Alfuzosin might not be more effective than placebo for treating FVD. The presence or the grade of BOO did not affect the results. A further study with sufficient power is needed to determine the efficacy of a1-AR blockers for the treatment of FVD.