DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20161111

Prazolin as a treatment for benign prostatic hypertrophy: a study in a tertiary care centre

Donepudi Pavan Kumar, Ravishankar K.

Abstract


Background: Benign prostatic hypertrophy (BPH) is one of the most common disorders effecting elderly men resulting in lower urinary tract symptoms (LUTS), including urinary frequency, retention, nocturia, intermittent force of the urinary stream, sensation of incomplete bladder emptying etc. The medical treatment preferred of late is with alpha-1 blockers or 5-alpha-reductase inhibitors or anti androgens. Prazosin, an older alpha-1 adrenergic blocker is considered a very useful drug in the treatment of PBH.

Methods: 97 patients, above 45 years of age and diagnosed with mild to moderate benign prostatic hyperplasia with lower urinary tract symptoms were included into the study. All patients were given prazosin 0.5 mg orally twice daily for a week. After 1 week, the night dose was increased to 1mg form 0.5 mg while the morning dose remained as 0.5 mg. All the patients were asked to record their symptoms for three days before each visit to the hospital. The parameters to record were nocturia, frequency, urgency, straining, force of urine and decreased force of urine, intermittency, and sensation of the urine residue. All these parameters were recorded on a scale of 0-5, where 0 is the total absence of symptoms and 5 is the most severe symptom.

Results: There was an improvement in the systolic and the diastolic blood pressure after 4 weeks of treatment. There was marked improvement in the urine output in the patients after 4 weeks of treatment. There was reduction in the nocturis and the frequency of urine by the patient. There was significant reduction in the urgency and the hesitancy of the urine. About 71 (80%) patients showed improvement in the sense of residual urine by the patients, while 66(74%)  showed improvement in the terminal dribbling of urine. 65 (73%) of the patients showed relief from prolonged micturation, while nocturia and day time frequency showed improvement in over 60% of the cases.

Conclusions:We therefore conclude that prazosin is also a very effective drug for the treatment of BPH, in terms of the urine outflow and decreased frequency and nocturia.

Background: Benign prostatic hypertrophy (BPH) is one of the most common disorders effecting elderly men resulting in lower urinary tract symptoms (LUTS), including urinary frequency, retention, nocturia, intermittent force of the urinary stream, sensation of incomplete bladder emptying etc. The medical treatment preferred of late is with alpha-1 blockers or 5-alpha-reductase inhibitors or anti androgens. Prazosin, an older alpha-1 adrenergic blocker is considered a very useful drug in the treatment of PBH.

Methods: 97 patients, above 45 years of age and diagnosed with mild to moderate benign prostatic hyperplasia with lower urinary tract symptoms were included into the study. All patients were given prazosin 0.5 mg orally twice daily for a week. After 1 week, the night dose was increased to 1mg form 0.5 mg while the morning dose remained as 0.5 mg. All the patients were asked to record their symptoms for three days before each visit to the hospital. The parameters to record were nocturia, frequency, urgency, straining, force of urine and decreased force of urine, intermittency, and sensation of the urine residue. All these parameters were recorded on a scale of 0-5, where 0 is the total absence of symptoms and 5 is the most severe symptom.

Results: There was an improvement in the systolic and the diastolic blood pressure after 4 weeks of treatment. There was marked improvement in the urine output in the patients after 4 weeks of treatment. There was reduction in the nocturis and the frequency of urine by the patient. There was significant reduction in the urgency and the hesitancy of the urine. About 71 (80%) patients showed improvement in the sense of residual urine by the patients, while 66(74%)  showed improvement in the terminal dribbling of urine. 65 (73%) of the patients showed relief from prolonged micturation, while nocturia and day time frequency showed improvement in over 60% of the cases.

Conclusions: We therefore conclude that prazosin is also a very effective drug for the treatment of BPH, in terms of the urine outflow and decreased frequency and nocturia.


Keywords


Prazosin, Benign prostate hypertrophy, Lower urinary tract symptoms

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References


Helfand M, Muzyk T, Garzotto M. Benign prostatic hyperplasia (BPH) management in primary care: Screening and therapy. Washington (DC): Department of Veterans Affairs (US). 2007.

Birkhoff JG. Natural history of benign prostatic hypertrophy. In: Hinman F Jr Boyarsky S eds. Benign prostatic hypertrophy. New York, Springer- Verlag. 2002;183:5-9.

Smith RA. Wake R, Soloway MS. Benign prostatic hyperplasia. Universal problem among aging men. Post grad-Med. 1988;83:79-85.

Chapple CR, Noble JG, Milroy EJG. Comparative study of selective alpha-l adrenoceptor blockade versus surgery in the treatment of prostatic obstruction. Br J Urol. 1993;12:822-5.

Generali JA, Cada DJ. Prazosin: benign prostatic hyperplasia. Hospital Pharm. 2013;48(3):196-7.

Roos NP, Wennberg JE, Malenka DJ. Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. N Eng J Med. 1989;320:1120-4.

Bruskewitz RC, Larsen EH, Madsen PO. Three year follow up urinary symptoms after trans urethral resection of the prostate. J Urol. 1986;136:613-5.

Meyhoff HH. Transurethral versus transvesical prostatectomy: clinical, urodynamic, renographic and economic aspects: a randomised study. Scand J Urol Nephrol. 1987;102:1-26.

Ball AJ, Feneley RCL, Abrams PH. The natural history of untreated prostatism. Br J urol. 1981;53:613-6.

AUA Practice Guidelines Committee AUA guideline on management of benign prostatic hyperplasia. Chapter 1: Diagnosis and treatment recommendations. J Urology. 2003;179:530-47.

Lepor H. Role of alpha adrenergic blocker in the treatment of benign prostatic hyperplasia. Prostate. 1990;3:75-84.

Buzelin JM, Hebert M, Blondin P. The PRAZALF group. Alpha blocking treatment with Alfuzosin in symptomatic benign prostatic hyperplasia: comparative study with prazosin. Br J Urol. 1973;72:922-7.

Caine M, Perlberg S, Shapiro E. Phenoxybenzamine for benign prostatic obstruction. Urology. 1981;17:542-6.

Chapple CR. Selective α1-adrenoceptor antagonists in benign prostatic hyperplasia: rationale and clinical experience. Eur Urol. 1996;29:129-44.

Beduschi M, Beduschi RR, Ostering JE. Alpha-blockade therapy for benign prostatic hyperplasia; from a non-selective to a more selective α1A-adrenergic antagonist. Urology. 1998;51:861-72.

Tsujii T. Comparison of prazosin, terazosin, and tamsulosin in the treatment of symptomatic benign prostatic hyperplasia: A short-term randomized multicentre study. Int J Urol. 2000;7:199-205.

Basalingappa S, Ignatus XJ, Madappa KM. Clinical evaluation of Prazosin in symptomatic benign prastatic hyperplasia - an Indian experience. Ind J Pharmacol. 1997;29:420-5.

Jensen D. Uninhibited neurogenic bladder treated with prazosin. Scand J Urol Nephrol. 1981;15:229-33.

Chapple CR. Medical therapy and quality of life. Eur Urol. 1998;34:16-7.