Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
Fusco F, Palmieri A, Ficarra V, et al
Eur Urol 2016;69:1091–101.
Expert's summary:
A systematic review and meta-analysis of the urodynamic effects of α-blockers was undertaken [1]
Expert's opinion:
α-Blockers are well recognised to improve lower urinary tract symptoms, but there is a common belief that they increase Qmax comparatively little, and hence do not greatly improve BOO. However, urodynamicists recognise that the relationship of pressure to flow is markedly dependent on the calibre of the outlet; a substantially occluded outlet (close to isovolumetric condition) ensures the detrusor contraction has maximal effect on intravesical pressure. A wide-open outlet will mean that flow occurs with barely-detectable intravesical pressure change (isotonic contraction)—a situation seen with voiding for some women. Increasing BOO pushes the individual's pressure-flow characteristics towards the isovolumetric end of the spectrum. The review by Fusco and colleagues [1]
Most studies using α-blockers for lower urinary tract symptoms/benign prostatic enlargement evaluate noninvasive external parameters, notably free uroflowmetry, symptom score, and postvoid residual urine. Formal urodynamic calculation of the change in BOOI is rarely undertaken after initiating α-blockers, so this systematic review is a valuable pointer to the less evident effects. However, there was rather limited published information, and only three of the seven randomised controlled trials were high-quality studies.
α-Blockers should not be dismissed as merely improving symptoms, since they have urodynamic effects which are potentially beneficial even if they are not necessarily overtly evident to external evaluation. Partial BOO gives rise to impairment of blood flow during each void [3]
Advisory Boards (speaker bureaux and researcher) for Allergan, Astellas, and Ferring.
