The effect of alpha blockers on uroflowmetric parameters in different voiding positions

Abstract

Introduction:We assessed the effect of different voiding positions on uroflowmetric parameters and post-void residual (PVR) urine volume in symptomatic benign prostatic hyperplasia (BPH) patients. We also evaluated the effect of alpha blockers on PVR in different voiding positions. Methods:The study was performed with 110 BPH patients over 50 years old. In total, 4 uroflowmetries were performed in all patients: 2 patients in the sitting position and 2 in the standing position. PVR was measured with transabdominal ultrasonography. Also, patients were divided into two groups according to the alpha adrenergic blocker treatment; the effect of this treatment on their uroflowmetric parameters in different positions was evaluated. Results: Maximum flow rate (Qmax) and average flow rate (Qave) were significantly higher in patients in the sitting position, but there were no differences in other uroflowmetric parameters and PVR volume (Qmax: 15.5±5.9 mL/s vs. 13.7±5.2 mL/s, Qave: 11.4±4.6 mL/s vs. 10.7± 3.9 mL/s, respectively; p < 0.05). The Qmax and Qave were significantly higher in sitting position, compared to the standing position, in both alpha adrenergic treatment and non-treated groups; again, there were no differences in other uroflowmetric parameters and PVR volume. Conclusion: Qmax and Qave values were significantly higher in the sitting position. Alpha blockers did not affect any change.

Urinating Standing versus Sitting: Position Is of Influence in Men with Prostate Enlargement. A Systematic Review and Meta-Analysis

“…A total of 69 abstracts were identified, 27 relevant publications were assessed in full-text for eligibility. Eleven studies [3], [7], [8], [14], [18], [26], [28], [30]–[33] fulfilled the inclusion criteria and were included in the meta-analysis (table 1). A snowball search of the references in these 11 articles did not yield additional articles.…”

“…A total of 800 participants were included, with the number of participants in individual studies ranging from 20 to 200. In five studies [3], [7], [26], [31], [33] only healthy men were included, in four studies [8], [14], [18], [28] only patients with LUTS, and in two studies [30], [32] both groups were studied. For studies with healthy participants all seven [3], [7], [26], [30]–[33] investigated Qmax, four measured TQ [3], [7], [26], [31], and four studies [3], [26], [30], [31] measured PVR.…”

“…For studies with healthy participants all seven [3], [7], [26], [30]–[33] investigated Qmax, four measured TQ [3], [7], [26], [31], and four studies [3], [26], [30], [31] measured PVR. For studies with LUTS patients, all six [8], [14], [18], [28], [30], [32] investigated Qmax, four studies [14], [18], [28], [32] measured TQ, and five studies [8], [14], [28], [30], [32] measured PVR. The study characteristics are shown in table 1.…”

“…Of the six LUTS studies, two [14], [30] defined the severity of LUTS by means of the IPSS and clinical examination, two [8], [28] by clinical examination only, one [18] by IPSS only, whereas one study [32] did not describe the severity at all. With regard to standardization of measurements, seven studies [3], [7], [14], [28], [30], [31], [33], used a private, non-observed clinical setting, one [18] instructed to measure at home, and three studies [8], [26], [32] did not describe the setting in which measurements took place.…”

“…For adequate outcome assessment, total bladder capacity should have been measured and the technique used for the assessment of urodynamic parameters should have been described. To ensure a valid comparison between standing and voiding position, voiding conditions should have been standardized and the following variables should have been taken into account: the influences of (1) the setting for the measurements (in a private, non-observed clinical setting, in an observed clinical setting or at home [21]), (2) the circadian rhythm [22], (3) the time since last ejaculation [23] and (4) defecation [5], [18], (5) changes in intra-abdominal pressure [24], [25], and (6) the accustomed voiding position [6], [8], [11], [14], [18], [26]–[28] on urodynamics.…”