Alpha-blockers have been used in women with voiding problem. However, the use of alpha-blockers in clinical practice to treat bothersome lower urinary tract symptom (LUTS) in women is based on these limited studies, some anecdotal case reports as well as local experience. This study aimed to evaluate the effects of the alpha-blocker on the symptoms in female patients.

We conducted a systematic review and meta-analysis on published a-priori protocols. We searched multiple data sources for published and unpublished randomized controlled trials in any language. Review outcomes included urologic symptom scores, quality of life and overall adverse events. We performed meta-analysis using RevMan 5.3 and rated the certainty of evidence (CoE) using GRADE.

A total of 1406 studies identified through our search, we included 12 studies (alpha-blockers vs. placebo: 5 studies, combination with alpha-blockers and other treatments vs. other treatments: 7 studies). Based on 4 studies comparing alpha-blockers and placebo, comprising 456 randomized participants, we are uncertain about the effects of alpha-blockers on urologic symptom scores based on IPSS (mean difference (MD): -1.13, 95% confidence interval (CI): -3.10 to 0.85; very low CoE), quality of life (MD: -0.48, 95% CI: -1.20 to 0.24; ; very low CoE), and overall adverse events (risk ratio (RR): 1.09, 95% CI: 0.55 to 2.15; ; very low CoE). Based on one studies comparing combination therapy with an alpha-blocker and anticholinergic and anticholinergic alone, comprising 144 randomized participants, we are uncertain about the effects of alpha-blocker on urologic symptom scores based on IPSS (MD: 0.30, 95% CI: -2.80 to 3.40; very low CoE) and quality of life (MD: 0.00, 95% CI: -0.56 to 0.56; very low CoE). There were no overall adverse events reported in the study. Based on 1 study comparing combination therapy with an alpha-blocker and cholinergic and cholinergic alone, comprising 81 randomized participants, we are uncertain about the effects of alpha-blocker on urologic symptom scores based on IPSS (MD: -3.06, 95% CI: -7.20 to 1.08; very low CoE). There were no quality of life and overall adverse events reported in the study.

From the present meta-analysis, alpha-blockers have been used to reduce storage LUTS as well as voiding LUTS in women. The inclusion criteria of most of the studies in this meta-analysis were based on symptoms using questionnaires regardless of the cause of LUTS. Therefore, this meta-analysis showed that symptom-based alpha-blockers treatment appeared to have little to no effects on urologic symptom scores, quality of life, and overall adverse events compared to placebo and other treatments in women.

Alpha-blockers treatment depending on subjective LUTS might have little effects on urologic symptom scores, quality of life, and overall adverse events compared to placebo and other treatments in women.

Ann Pharmacother 2014;48:711-22