ABSTRACT
PURPOSE: Alpha-blockers have been demonstrated to be safe and effective in the treatment of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) in men. Patients often feel inconvenience because of the cost and long term nature of the therapy. The purpose of this study was to determine the efficacy and safety of every other day alpha-blocker therapy in men with LUTS/BPH. MATERIALS AND METHODS: Men with LUTS, 50 years of age or older, were entered into this trial. 137 patients were treated with 10mg of alfuzosin once a day for the initial 3 months. After 3 months, 95 patients showed improvements in the International Prostate Symptom Score (IPSS) of more than 30% as well as a Qmax of more than 30%. We randomly divided those 95 patients into three groups. Group I (32 patients) continued to take 10mg of alfuzosin every day, group II (32 patients) took 10mg of alfuzosin every other day and group III (31 patients) stopped the alfuzosin; 3 months later the IPSS, Qmax and side effects of three groups were measured. RESULTS: At 3 months, the mean IPSS and Qmax of the 95 patients decreased and increased from 21.5 to 9.5 and from 8.0ml/sec to 15.8ml/sec, respectively. After 3 months, the mean IPSS of groups I and II were 10.2 and 11.3, respectively. The Qmax of groups I and II were 16.6 and 17.8 ml/sec, respectively. There were no significant differences between the IPSS and Qmax of groups I and II. Also, there was no significant side effect in any group. 58% of group III patients restart alfuzosin within 3 months. CONCLUSIONS: In cases that show a good response to short term therapy of alfuzosin, every other day alfuzosin therapy might be a good alternative choice for the convenience of patients with LUTS. Also, the role of intermittent alfuzosin therapy should be determined in a large cohort of men with LUTS/BPH. (Korean J Urol 2005;46:366-369)
Subject(s)
Humans , Male , Cohort Studies , Lower Urinary Tract Symptoms , Prostate , Prostatic HyperplasiaABSTRACT
PURPOSE: Cystoscopy is very common and is one of the major office based procedures used in urologic clinics. However, a majority of patients complain of fear, pain, and discomfort when performing the procedure in an alert state. Routine administration of sedative and analgesic drugs is widely provided for gastorintestinal endoscopy to prevent patient discomfort and increase tolerance. Based on this, we investigated the safety and efficacy of midazolam induced sedative cystoscopy. MATERIALS AND METHODS: One hundred and twenty patients were enrolled in this study. They were divided into two groups; group I (n=80) consisted of patients who were sedated by midazolam 2.5mg IV before cystoscopy, and group II (n=40) consisted of patients who were not sedated and diclopenac 90mg was injected in them intramuscularly before cystoscopy to prevent pain. All patients in group I were reversed from the sedative state by flumazenil 0.5mg IV right after the completion of the cystoscopic procedure. The two groups were not significantly different in their age, sex, and weight distribution (p>0.05). Blood pressure, pulse, and respiratory rates were monitored pre-, intra-, and post procedure. The status of consciousness was monitored every three minutes by the OAA/S (Observer's Assessment of Alertness/Sedation) scale. Pain scale, anxiety scale, satisfaction score from patients and operators were measured using a specified questionnaire. RESULTS: In group I, the pain scale and anxiety scale were significantly reduced compared to group II (p<0.001). There were temporary changes in blood pressure and pulse rate in group I, but they were not clinically significant and no specific management was required. Group I patients were significantly more satisfied with their procedures compared to the patients of group II (p<0.001). CONCLUSIONS: Midazolam induced sedative cystoscopy can be applied safely and effectively as an outpatient base procedure. Further, we expect to apply this sedative procedure to other urologic procedures.