Urodynamic Effect of Acute Alpha-Receptor Blockade in Patients With Bladder Neck Dysfunction

TL;DRAbstract

Forty-nine male patients, median age 35 years (range 16-59) with bladder neck dysfunction (BND) were investigated before and after intravenous administration of phentolamine to evaluate the effect of acute alpha-blockade on micturition parameters and to identify patients, who might benefit from alpha-blocking therapy. Under the influence of phentolamine we found a significant decrease in the mean values of maximal urethral closure pressure (MUCP), pressure at the bladder neck and prostatic profile length (PPL), a decreased bladder capacity, a more complete bladder emptying, and a small but significant improvement in peak flow rate (PFR). However, according to a flow-rate nomogram analysis with correction for voided volume, only two patients significantly improved their PFR. A subgroup of 20 "responders", defined as patients with any improvement of PFR after phentolamine, not caused by increased detrusor pressure was characterized by significantly longer opening time and lesser maximal

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