α1-Blockers for the treatment of recurrent urinary tract infections in women with dysfunctional voiding: A prospective randomized study

ObjectivesTo evaluate the therapeutic effects of tamsulosin on recurrent urinary tract infections in women with dysfunctional voiding. MethodsA total of 155 women with recurrent urinary tract infections and dysfunctional voiding were included and randomly assigned to the following groups: uroflowmetry biofeedback (group1), 1-adrenoceptor antagonists (group2), uroflowmetry biofeedback combined with 1-adrenoceptor antagonists (group3) and no treatment (group4). Patients were evaluated by the American Urological Association Symptom Index at 3, 6 and 12 months. Urodynamics was carried out in patients of groups1, 2, and 3 at 3, 6 and 12 months, whereas urodynamics was only carried out at 12 months in group4. All patients were followed up for 1 year with monthly urine cultures. ResultsThe incidence of storage and emptying symptoms decreased significantly at 3, 6 and 12 months. Mean flow rate, flow time and voiding volume increased significantly (with a better outcome in patients of group3), whereas post-void residual urine decreased. Mean opening detrusor pressure and detrusor pressure at maximum flow decreased significantly (with a better outcome in patients of group3). Mean urethral closure pressure and maximum urethral closure pressure decreased significantly with a more significant decrease for patients in group3. The prevalence of urinary tract infection decreased significantly in all groups after treatment, and this decrease remained stable during the follow up. ConclusionsIn women with dysfunctional voiding and recurrent urinary tract infection, tamsulosin associated with uroflowmetry biofeedback might be an effective and safe treatment option for improving urinary symptoms and quality of life.