Mode of action of α₁‐adrenoreceptor antagonists in the treatment of lower urinary tract symptoms

OnabotulinumtoxinA injection therapy in men with LUTS due to primary bladder‐neck dysfunction: Objective and patient‐reported outcomes

“…This finding is in agreement with those of previous studies . Although the underlying mechanism remains to be clarified, the improvement of storage LUTS is of interest because urgency and frequency are the most frequent patient‐reported most bothersome symptoms and are often maintained after medical treatment …”

α1-adrenergic receptor antagonists versus placebo for female lower urinary tract symptoms: A meta-analysis

“…During the micturition phase, the bladder neck and urethral muscle relax to allow the detrusor to contract and expel urine without major resistance. The α 1D AR predominates in the female detrusor and the α 1A AR is expressed at higher levels than other α 1 AR subtypes in the female urethra (including the bladder neck) (9)(10)(11)(12). Therefore, the efficacy of α 1 ARAs for the treatment of female LUTS may be explained by the targeting of two possible mechanisms.…”

“…However, the application of molecular biological methods in the last few years has confirmed a total of nine AR subtypes: α 1A (formerly named α 1c ), α 1B , α 1D , α 2A , α 2B , α 2C , β 1 , β 2 and β 3 (8). The α 1D AR predominates in the female detrusor and spinal cord (9,10). The α 1A AR is expressed at significantly higher levels than other α 1 AR subtypes are in the female urethra (11,12).…”

A 12‐Week, Open Label, Multi‐Center Study to Evaluate the Clinical Efficacy and Safety of Silodosin on Voiding Dysfunction in Patients with Neurogenic Bladder

“…Alpha-blockers may have different actions on the lower urinary tract function depending on the selectivity to α 1 -adrenoceptor subtypes as well as the capability of passing the blood brain barrier (BBB). 7 As an example of central action of α-blockers on the neural control of the external urethral sphincter, prazosin exerted an inhibitory action on pudendal nerve-dependent urethral constriction by passing the BBB. 8 There are, however, very few reports available regarding clinical efficacy of silodosin for neurogenic bladder.…”