MURAT ŞAMLI, ÇETİN DİNÇEL
Kocatepe Tıp Dergisi - 2002;3(8):119-129
Objective: Medical treatment of the BPH is one of the alternatives among a variety of therapeutic options. Doxazosin and terazosin are the most widely used molecules in the treatment of BPH. We compared the effectivity of these molecules by switching the drug in those who did not benefit from the first drug. Methods: This was a prospective randomized study. Patients in the study were similar in age, prostatic weight, International Prostatic Symptom Score (I-PSS), uroflow parameters and PSA levels. Fifty men (mean age 59.4 years, SD 7.6, range 48-78) received either doxazosin (25 men), or terazosin (25 men), once daily at night. Patients were evaluated at one, 2 and 3 months. Improvement in I-PSS and the maximal flow rate (Qmax) by minimum 20% was accepted as improvement. Patients who showed improvement in none of the parameters have switched the drug and these patients were followed in the next 3 months. Results: Of the 25 men using doxazosin, 11 (44%) showed improvement both in I-PSS and Qmax at 3 months. Of the 25 men using terazosin, 10 (40%) showed improvement both in I-PSS and Qmax at 3 months (p>0.05). After 3 months of treatment, the peak urinary flow rate increased significantly (p< 0.001) for both doxazosin (+4.5 mL/s) and terazosin (+3.1 mL/s) groups. The International Prostatic Symptom Score improved significantly (p< 0.01) with both alpha-blockers after 3 months of treatment in these groups. Nineteen patients, who did not show improvement in any of the parameters, switched the drug. Of the patients who switched the drug, 2 (4%) showed improvement both in I-PSS and in the peak urinary flow rate, 2 (4%) showed improvement only in I-PSS but not in the peak urinary flow rate and 15 (30%) did not show improvement in any of the parameters. Conclusion: These results suggest that alpha blockade with either doxazosin or terazosin is effective in men with symptomatic BPH. Two of the alpha-blocking molecules showed equal effectivity in the treatment of BPH. If one of the molecules is ineffective in the treatment of BPH, then the other molecule will probably be ineffective.
