Intermittent Therapy May Be an Option for LUTS

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Intermittent alpha blocker therapy is a feasible strategy for men suffering from lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO), a researcher has concluded.

Muhammad A. Bulbul, MD, of the department of surgery at the American University of Beirut in Lebanon, studied 100 patients aged 47 to 76 years with bothersome LUTS secondary to BPO. He started patients on alpha blocker monotherapy (doxazosin, alfuzosin, or tamsulosin).

He asked patients to stay on treatment for three months, but if patients experienced significant symptomatic improvement after two weeks, they could stop taking their alpha blocker. Dr. Bulbul instructed patients to stay off therapy for as long as they were not bothered or to resume taking their medication as soon as their bothersome symptoms recurred.

Eighty-four patients responded to treatment within two weeks. Of the 84 patients, 34 (40%) did not feel the need to resume treatment for three months after discontinuing and 50 (60%) felt the need to resume treatment at variable time intervals (one to 24 days) after stopping. Prostate size and type of alpha blocker did not influence patient behavior.

Dr. Bulbul reported findings at the 24th Annual European Association of Urology Congress in Stockholm. A trial of withholding alpha blocker therapy is warranted in men with bothersome LUTS secondary to BPO as long as patients are not bothered by symptoms, Dr. Bulbul concluded. The strategy could have cost-saving implications in developing countries, he noted.

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