Effect of Alpha Blocker on Lower Urinary Tract Symptoms in Women: Systematic Review and Meta-Analysis

Kim H1, Kim K2, Yoon H3, Choi J4, Kim J5, Kim S6

Research Type

Clinical

Abstract Category

Female Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Best in Category Prize: Female Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction
Abstract 146
Female Lower Urinary Tract Symptoms
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1. Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea, 2. Department of Urology, Gachon University School of Medicine, Gil Medical Center, Incheon, Korea, 3. Department of Urology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea, 4. Department of Urology, Ajou University College of Medicine, Suwon, Korea, 5. Department of Urology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea, 6. Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
Presenter
S

Su Jin Kim

Links

Abstract

Hypothesis / aims of study
Alpha-blockers have been used in women with voiding problem. However, the use of alpha-blockers in clinical practice to treat bothersome lower urinary tract symptom (LUTS) in women is based on these limited studies, some anecdotal case reports as well as local experience. This study aimed to evaluate the effects of the alpha-blocker on the symptoms in female patients.
Study design, materials and methods
We conducted a systematic review and meta-analysis on published a-priori protocols. We searched multiple data sources for published and unpublished randomized controlled trials in any language. Review outcomes included urologic symptom scores, quality of life and overall adverse events. We performed meta-analysis using RevMan 5.3 and rated the certainty of evidence (CoE) using GRADE.
Results
A total of 1406 studies identified through our search, we included 12 studies (alpha-blockers vs. placebo: 5 studies, combination with alpha-blockers and other treatments vs. other treatments: 7 studies). Based on 4 studies comparing alpha-blockers and placebo, comprising 456 randomized participants, we are uncertain about the effects of alpha-blockers on urologic symptom scores based on IPSS (mean difference (MD): -1.13, 95% confidence interval (CI): -3.10 to 0.85; very low CoE), quality of life (MD: -0.48, 95% CI: -1.20 to 0.24; ; very low CoE), and overall adverse events (risk ratio (RR): 1.09, 95% CI: 0.55 to 2.15; ; very low CoE). Based on one studies comparing combination therapy with an alpha-blocker and anticholinergic and anticholinergic alone, comprising 144 randomized participants, we are uncertain about the effects of alpha-blocker on urologic symptom scores based on IPSS (MD: 0.30, 95% CI: -2.80 to 3.40; very low CoE) and quality of life (MD: 0.00, 95% CI: -0.56 to 0.56; very low CoE). There were no overall adverse events reported in the study. Based on 1 study comparing combination therapy with an alpha-blocker and cholinergic and cholinergic alone, comprising 81 randomized participants, we are uncertain about the effects of alpha-blocker on urologic symptom scores based on IPSS (MD: -3.06, 95% CI: -7.20 to 1.08; very low CoE). There were no quality of life and overall adverse events reported in the study.
Interpretation of results
From the present meta-analysis, alpha-blockers have been used to reduce storage LUTS as well as voiding LUTS in women. The inclusion criteria of most of the studies in this meta-analysis were based on symptoms using questionnaires regardless of the cause of LUTS. Therefore, this meta-analysis showed that symptom-based alpha-blockers treatment appeared to have little to no effects on urologic symptom scores, quality of life, and overall adverse events compared to placebo and other treatments in women.
Concluding message
Alpha-blockers treatment depending on subjective LUTS might have little effects on urologic symptom scores, quality of life, and overall adverse events compared to placebo and other treatments in women.
References
  1. Ann Pharmacother 2014;48:711-22
Disclosures
Funding None Clinical Trial No Subjects Human Ethics not Req'd Meta-analysis Helsinki not Req'd Meta-analysis Informed Consent No
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