Place des alphabloquants chez la femme : revue de la littérature

INTRODUCTION Marketing authorization of alphablockers is limited principally to men with benign hypertrophy of prostate. The objective of this review is to evaluate clinical and urodynamic improvement of alphablockers in women. METHOD A review of the literature was carried out on all prospective studies about the use of alphablockers in women with urination disorders. RESULTS Seventeen articles have been included. The selected articles were classified according to the studied population: lower urinary tract disorders, bladder emptying disorders without details on mechanism, bladder outlet obstruction, detrusor hypoactivity overactive bladder. Four studies were randomized against placebo. There was an improvement in the IPSS in 8 studies going as far as a decrease of 11,7 points (4.6 vs. 16.3 P<0.05). The voiding IPSS subscore was improved overall in 8 studies with a decrease of up to 6,2 points (9.6±5.5 vs. 14.8±4 P<0.01). Two trials showed an improvement of clinical scores versus placebo with an improvement of IPSS from -11.7 vs -9.5 (P<0.05) and -5.6 vs -2.6 (P<0.05). Urodynamic parameters were also often improved with a decrase of Qmax going to+5.8mL/s (P<0.05). Alphablocker also appear to improve non obstructive voiding disorders. The benefit in overactive bladder seems limited. CONCLUSION Alphablockers may be indicated in voiding disorders of women. Their exact role must be established.