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Terazosin therapy for patients with female lower urinary tract symptoms: a randomized, double-blind, placebo controlled trial

Low BY, Liong ML, Yuen KH, Chee C, Leong WS, Chong WL, et al.

J Urol, 2008 Apr;179(4):1461-9.
PMID: 18295277 DOI: 10.1016/j.juro.2007.11.060

PURPOSE: We determined the clinical efficacy and safety of terazosin in the treatment of patients with female lower urinary tract symptoms.
MATERIALS AND METHODS: A total of 100 females 20 to 70 years old who met the inclusion criteria of total International Prostate Symptom Score 8 or greater, symptom duration 1 or more months, and did not meet any exclusion criteria were entered into the study. Subjects were randomized to receive terazosin or placebo in titrated dose from 1 mg od, 1 mg twice daily to 2 mg twice daily during 14 weeks. Successful treatment outcomes use primary end point of International Prostate Symptom Score quality of life 2 or less and secondary end point of total International Prostate Symptom Score 7 or less. Other outcome measures included International Prostate Symptom Score individual item scores, King's Health Questionnaire quality of life domains, objective assessment parameters of 24-hour frequency volume chart, maximum flow rate and post-void residual urine.
RESULTS: Using a primary end point, 32 of 40 (80%) evaluable terazosin subjects responded in contrast to 22 of 40 (55%) evaluable placebo subjects (p <0.02). The secondary end point revealed a successful outcome in 85% of terazosin subjects vs 55% in placebo (p <0.01). Of the 7 International Prostate Symptom Score individual item scores, only item scores of frequency and straining showed statistically significant reductions with terazosin (p <0.01). All King's Health Questionnaire quality of life domains except domain of severity measures showed statistically significant improvement with terazosin (p <0.05). There were no differences between treatment groups in all objective assessment parameters. Of all evaluable subjects 23 of 40 (58%) on placebo experienced adverse events vs 16 of 40 (40%) on terazosin (p >0.05).
CONCLUSIONS: Terazosin proved to be more effective and safe than placebo in patients with female lower urinary tract symptoms.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use*
The male marital satisfaction following treatment for lower urinary tract symptoms

Quek KF, Loh CS, Low WY, Razack AH, Dublin N

J Sex Marital Ther, 2003 Mar-Apr;29(2):173-6.
PMID: 12623769
Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use*
The psychological effects of treatments for lower urinary tract symptoms

Quek KF, Low WY, Razack AH, Loh CS

BJU Int, 2000 Oct;86(6):630-3.
PMID: 11069367

OBJECTIVE: To assess and evaluate the level of depression, anxiety and psychiatric status in patients with lower urinary tract symptoms (LUTS) before and after treatment by surgery or drugs.
PATIENTS AND METHODS: The study included 123 patients (mean age 64.6 years, SD 7. 95) with LUTS who were treated medically (with alpha-blockers, i.e. terazosin, prazosin, doxazosin and alfuzosin), and 52 patients (mean age 69.6 years, SD 7.94) with LUTS and confirmed to have benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Both groups were assessed at baseline and 3 months after treatment using standardized questionnaires (the Beck Depression Inventory, the State-Trait Anxiety Inventory and the General Health Questionnaire-12).
RESULTS: Patients before TURP were significantly more depressed, worried and psychiatrically morbid than were those before medical treatment. Three months after medical and surgical treatment, there was significantly less depression, anxiety and psychiatric morbidity in the TURP than in the medication group.
CONCLUSIONS: TURP is a better treatment than medication for minimising anxiety, depression and psychiatric morbidity after treatment in patients with LUTS, but causes greater psychological stress before treatment.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use
Terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome: a randomized, placebo controlled trial

Cheah PY, Liong ML, Yuen KH, Teh CL, Khor T, Yang JR, et al.

J Urol, 2003 Feb;169(2):592-6.
PMID: 12544314 DOI: 10.1097/01.ju.0000042927.45683.6c

PURPOSE: We evaluate terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome.
MATERIALS AND METHODS: The study included 100, 20 to-50-year-old subjects who met the consensus criteria for chronic prostatitis/chronic pelvic pain syndrome and had not received previous alpha-blockers. Subjects were randomized to receive terazosin with dose escalation from 1 to 5 mg. daily or placebo for 14 weeks. The primary criterion for response was scoring 2 or less ("delighted-to-mostly satisfied") on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) quality of life item. The secondary criterion for response was greater than 50% reduction in NIH-CPSI pain score at 14 weeks. Other outcomes included total and NIH-CPSI domain scores, International Prostate Symptom Score, peak urinary flow rate, post-void residual urine and adverse effects.
RESULTS: Using the primary criterion 24 of 43 evaluable subjects (56%) responded in the terazosin group compared to 14 of 43 (36%) in the placebo group (p = 0.03). Using the secondary criterion 26 of 43 subjects (60%) responded in the terazosin group compared to 16 of 43 (37%) in the placebo group (p = 0.03). The terazosin group had greater reductions (p <0.05) in NIH-CPSI total score, individual domain scores and International Prostate Symptom Score than the placebo group. There was no difference in peak urinary flow rate or post-void residual. In the terazosin group 18 patients (42%) had side effects compared to 9 (21%) in the placebo group (p = 0.04).
CONCLUSIONS: Terazosin proved superior to placebo for patients with chronic prostatitis/chronic pelvic pain syndrome who had not received alpha-blockers previously.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use*
Fulltext Sexual function outcomes following treatment for lower urinary tract symptoms. A one-year study

Quek KF, Razack AH, Chua CB, Low WY, Loh CS

Med J Malaysia, 2003 Dec;58(5):735-42.
PMID: 15190661

The aim of this study was to assess the effects of treating lower urinary tract symptoms (LUTS) on the quality of sexual function in a one-year follow up. A total of 116 patients with LUTS received alpha-blocker treatment, 111 patients underwent transurethral resection of the prostate (TURP) and 70 patients with renal stones, with no or mild symptoms served as a control group. The patients were assessed at baseline, three months, six months and twelve months using the International Index of Erectile Function (IIEF-15). The surgical group exhibited some changes in the domain of IIEF-15. Patients in the medical group showed improvement in erectile function and intercourse satisfaction, while orgasmic, overall sexual satisfaction and sexual drive were relatively unchanged. In contrast, the surgical group suffered retrograde ejaculation and overall sexual dissatisfaction after undergoing TURP. TURP has been found to be associated with retrograde ejaculation intercourse and overall sexual dissatisfaction.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use
Fulltext Role of α1-blockers in the current management of hypertension

Li H, Xu TY, Li Y, Chia YC, Buranakitjaroen P, Cheng HM, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1180-1186.
PMID: 36196467 DOI: 10.1111/jch.14556

There is emerging evidence that α1-blockers can be safely used in the treatment of hypertension. These drugs can be used in almost all hypertensive patients for blood pressure control. However, there are several special indications. Benign prostatic hyperplasia is a compelling indication of α1-blockers, because of the dual treatment effect on both high blood pressure and lower urinary tract symptoms. Many patients with resistant hypertension would require α1-blockers as add-on therapy. Primary aldosteronism screen is a rapidly increasing clinical demand in the management of hypertension, where α1-blockers are useful for blood pressure control in the preparation for the measurement of plasma aldosterone and renin. Nonetheless, α1-blockers have to be used under several considerations. Among the currently available agents, only long-acting α1-blockers, such as doxazosin gastrointestinal therapeutic system 4-8 mg daily and terazosin 2-4 mg daily, should be chosen. Orthostatic hypotension is a concern with the use of α1-blockers especially in the elderly, and requires careful initial bedtime dosing and avoiding overdosing. Fluid retention is potentially also a concern, which may be overcome by combining an α1-blocker with a diuretic.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use
Initial, long-term, and durable responses to terazosin, placebo, or other therapies for chronic prostatitis/chronic pelvic pain syndrome

Cheah PY, Liong ML, Yuen KH, Teh CL, Khor T, Yang JR, et al.

Urology, 2004 Nov;64(5):881-6.
PMID: 15533470 DOI: 10.1016/j.urology.2004.06.041

OBJECTIVES: To evaluate the initial, long-term, and durable response rates to terazosin, placebo, or other therapies in patients with chronic prostatitis/chronic pelvic pain syndrome.
METHODS: A total of 100 subjects, aged 20 to 50 years, who met the National Institutes of Health criteria for chronic prostatitis/chronic pelvic pain syndrome and had not previously been treated with alpha-blockers, were entered in a 14-week, double-blind comparison of terazosin or placebo therapy. Nonresponders and responders with subsequent relapse were treated with terazosin or other medications (open label). The criterion for response was a score of 0 to 2 on the National Institutes of Health Chronic Prostatitis Symptom Index quality-of-life item. The initial response was evaluated at week 14, and the long-term response was evaluated after a median of 38 weeks (range 34 to 42), regardless of any additional treatment. A durable response was defined as an initial response without additional treatment.
RESULTS: Of the 43 patients in the terazosin group, 24 (56%) had an initial response compared with 14 (33%) of 43 subjects in the placebo group (P = 0.03). Long-term responses were noted in 23 (56%) of 41 assessable subjects treated with terazosin initially compared with 12 (32%) of 38 assessable subjects treated with placebo (P = 0.03). Of the nonresponders and initial responders with relapse, 7 (41%) of 17 subjects responded to terazosin compared with 7 (21%) of 34 given other treatment (P = 0.12). Durable responses occurred in 18 (44%) of the 41 assessable patients treated initially with terazosin and in 6 (16%) of 38 treated initially with placebo (P = 0.01).
CONCLUSIONS: Patients treated with terazosin were more likely to have initial, long-term, and durable responses than those treated with placebo.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use*
Nocturia in patients with benign prostatic hyperplasia: evaluating the significance of ageing, co-morbid illnesses, lifestyle and medical therapy in treatment outcome in real life practice

Singam P, Hong GE, Ho C, Hee TG, Jasman H, Inn FX, et al.

Aging Male, 2015 Jun;18(2):112-7.
PMID: 25690022 DOI: 10.3109/13685538.2015.1011614

The aim of study was to evaluate the influence of ageing, lifestyle, and co morbid illnesses on treatment outcome of nocturia among men with BPH.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use
Fulltext Effectiveness of antihypertensive drugs in hypertensive patients with end stage renal failure

Kumolosasi E, Ng WB, Abdul Aziz SA

Med J Malaysia, 2012 Aug;67(4):379-85.
PMID: 23082445 MyJurnal

Hypertension has been identified as one of the causes for end stage renal failure (ESRF) and is likely to worsen kidney function. This retrospective study was carried out at a tertiary hospital in Malaysia with the objective of determining the effectiveness of combination antihypertensive drugs in hypertensive patients with ESRF admitted between 2006 and 2008. Patients with incomplete data and who were on monotherapy were excluded from this study. Although six different combinations gave significant reductions in systolic blood pressure (SBP) (13.38 +/- 9.11 mmHg, p < 0.05) and diastolic blood pressure (DBP) (6.03 +/- 11.39 mmHg, p < 0.05), 69.16% patients did not achieve target blood pressure (BP) (< or = 130/80 mmHg). Combination of beta blocker (BB) with calcium channel blocker (CCB) was the most commonly used. The CCB-diuretic regimen achieved highest percentage of BP control compared to others (40%). Comparison of blood pressure reduction between different combinations of antihypertensive drugs were not significant (p > 0.05) except for CCB-diuretics and BB-CCB-alpha blocker. The findings suggested better BP control with CCB-diuretic relative to other combinations used.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use
Fulltext The effects of treating lower urinary tract symptoms on sexual function

Quek KF, Loh CS, Low WY, Razack AH

Med J Malaysia, 2001 Jun;56(2):158-66.
PMID: 11771075

We prospectively evaluated the effect of the treatment of lower urinary tract symptoms (LUTS) on sexual function. The patients were assessed by using the International Index of Erectile Function (IIEF-15) inventory at baseline and three months after medical (alpha-blockers) or surgical treatment (transurethral resection of the prostate, TURP). Following treatment, there were improvement in erectile function and intercourse satisfaction while orgasmic, overall satisfaction and sexual drive were relatively unchanged in the medication group. Patients who had surgical treatment suffered retrograde ejaculation, dissatisfaction in sexual intercourse and overall sexual satisfaction compared to patients who were on alpha-blockers.
Study site: Urology ward and clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use
Fulltext The effects of treating lower urinary tract symptoms on health-related quality of life: a short-term outcome

Quek KF, Loh CS, Low WY, Razack AH, Chua CB

Singapore Med J, 2002 Aug;43(8):391-8.
PMID: 12507023

This study examined the effects of treatment of lower urinary tract symptoms (LUTS) on the health-related quality of life (physical/functional, mental, social and global aspect), pain and prostatic symptoms.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use
Unusual presentation of pheochromocytoma with ischemic sigmoid colitis and stenosis

Tan F, Thai AC, Cheah WK, Mukherjee JJ

South. Med. J., 2009 Oct;102(10):1068-70.
PMID: 19738530 DOI: 10.1097/SMJ.0b013e3181b571e6

A 45-year-old woman with poorly controlled hypertension and diabetes mellitus presented with left iliac fossa pain, constipation alternating with diarrhea, and weight loss. She had been diagnosed with idiopathic cardiomyopathy five years previously. Echocardiogram had shown a left ventricular ejection fraction (LVEF) of 35%; coronary angiogram was normal. Colonoscopy revealed sigmoid colitis with stenosis. Abdominal computed tomography revealed a 5 cm right adrenal tumor. Twenty-four hour urinary free catecholamines and fractionated metanephrine excretion values were elevated, confirming pheochromocytoma. Her colitis resolved after one month of adrenergic blockade. Repeat echocardiogram showed improvement of LVEF to 65%. After laparoscopic right adrenalectomy, the patient's hypertension resolved, and diabetic control improved. Timely management avoided further morbidity and potential mortality in our patient.

Matched MeSH terms: Adrenergic alpha-Antagonists/therapeutic use