Alpha-1 Adrenergic Receptor Blockers for the Treatment of Lower Urinary Tract Symptoms in Women: A Systematic Review and Meta-Analysis

초록

Purpose: To assess the effectiveness of alpha-1 adrenergic receptor blockers (alpha 1-blockers) in the treatment of female lower urinary tract symptoms (LUTS). Methods: A literature search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases. Fourteen studies with 1,319 patients were ultimately included. The study comprised 2 analyses: a comparison of urinary symptom scores, maximal flow rate (Qmax), and postvoid residual (PVR) urine volume before and after alpha 1-blocker administration in 8 prospective, open-label studies and 5 randomized clinical trials (RCTs); and an evaluation of the same variables in alpha 1-blocker and placebo groups in 4 RCTs. Results: The first meta-analysis showed that, following treatment, patients exhibited statistically significant symptom relief (mean difference [MD], -5.85; 95% confidence interval [CI], -7.71 to -3.99; P < 0.00001), increased Qmax (MD, 3.67 mL/sec; 95% CI, 2.76-4.59 mL/sec; P < 0.00001), and decreased PVR volume (MD, -28.46 mL; 95% CI, -34.99 to -21.93 mL; P < 0.00001). In the second meta-analysis, alpha 1-blockers demonstrated significant symptom relief relative to placebo (MD, -1.60; 95% CI, -2.68 to -0.51; P = 0.004). However, no significant differences were observed in Qmax (MD, 0.05 mL/sec; 95% CI, -0.74 to 0.83 mL/sec, P = 0.91) and PVR (MD, -8.10 mL; 95% CI, -32.32 to 16.12 mL, P = 0.51) between the alpha 1-blocker and placebo groups. Conclusions: These analyses suggest that alpha 1-blockers are effective in the treatment of female LUTS patients. However, the effect of alpha 1-blockers on female LUTS should be assessed according to the underlying cause, and the role of alpha 1-blockers in combination therapy with other drugs should also be investigated.

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