No abstract available.
Doxazosin* ; Hypertension*

No abstract available.
*Antihypertensive Agents ; *Doxazosin ; Humans ; Liver Cirrhosis

PURPOSE: An economic analysis of pharmacological therapy and transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia (BPH) was conducted. MATERIALS AND METHODS: Twenty six patients had undergone TURP from January to June 2000 were enrolled in this study. The costs associated with this group of patients were compared with those of 7 patients treated with medication (doxazosin, terazosin, tamsulosin, and finasteride only and alpha-blocker with finasteride). RESULTS: The mean cost for TURP was 1,900,000 won. The most expensive medical therapy was finasteride, which was followed by tamsulosin, terazosin, and doxazosin, with an estimated 12-month cost of 817,000won, 695,000won, 396,000won, and 372,000won respectively. The costs associated with doxazosin remained lower than those associated with TURP for approximately 5.3 years (the corresponding break-even point was 2.4 years for finasteride vs. TURP). CONCLUSIONS: Among the pharmacological therapies, doxazosin is the most cost effective. TURP was more cost effective than doxazosin therapy after 5.3 years. In view of the cost-effectiveness, TURP may be considered as the mode of primary therapy for the patients with severe symptoms of BPH.
Doxazosin ; Finasteride ; Humans ; Prostate* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

PURPOSE: We administered doxazosin gastrointestinal therapeutic system (GITS) to women with non-neurogenic voiding dysfunction to evaluate its therapeutic effects. MATERIALS AND METHODS: Women who had voiding dysfunctions for at least 3 mo were included. Inclusion criteria were age > or =18yr, an International Prostate Symptom Score (IPSS) > or =15, and a maximum flow rate (Qmax) <15mL/sec and/or postvoid residual (PVR) > or =150mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram. After 4 weeks, treatment outcomes were evaluated. RESULTS: Sixty-two patients were evaluated of mean age 53.8 (32-78)yr. According to the Blaivas-Groutz nomogram, 24 patients had no or mild obstruction (group A) and 38 had moderate or severe obstruction (group B). After treatment, mean IPSS decreased significantly and by more than 5 points in 42 (67.7%). Mean bother scores, Qmax, and PVR also changed significantly. Thirty-seven (59.7%) showed Qmax increases of more than 50%. No significant difference were observed between the groups in terms of IPSS, bother score, Qmax, PVR, micturition frequencies, or functional bladder capacity changes. Adverse effects related to medication were de novo stress urinary incontinence (SUI) (1 case) and underlying SUI aggravation (1 case). By satisfaction assessments, 16 patients (25.8%) were 'mainly satisfied', 31 (50%) were 'slightly satisfied', and 15 (24.2%) were 'dissatisfied'. CONCLUSION: Doxazosin GITS was found to be effective in female patients with voiding dysfunction regardless of obstruction grade. The alpha-adrenoceptor antagonists should be viewed as initial treatment option for women with a non-neurogenic voiding dysfunction.
Doxazosin* ; Female ; Humans ; Nomograms ; Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urination

Doxazosin is an adrenergic alpha-1 receptor antagonist used to treat lower urinary tract symptoms that are common in prostatic hyperplasia. To our knowledge, few cases of gynecomastia and mastodynia, as a complication of adrenergic alpha-1 receptor antagonist, have been reported to date; no cases have been reported in Korea. We describe a case involving a 78-year-old man treated for prostatic hyperplasia with 13 months of doxazosin. He complained about unilateral gynecomstia and mastodynia. Five months after the discontinuation of doxazosin, the gynecomastia was significantly improved. This is the first reported case of gynecomastia and mastodynia associated with doxazosin use in Korea.
Aged ; Doxazosin* ; Gynecomastia* ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Male ; Mastodynia ; Prostatic Hyperplasia

PURPOSE: Doxazosin has gained wide acceptance as a pharmacotherapeutic agents for the treatment of BPH. As a selective alpha-1 blocker, it is known to reduce symptom scores and improve flow rates. However, the correlation not been fully established. in this study we investigated that improvements of clinical parameters, such as the symptom score, storage symptom score, voiding symptom score, bother score, peak flow, post-voiding residuals and prostate volume, are statistically related to the subjective satisfaction in patients receiving doxazosin pharmacotherapy for the management of BPH. MATERIALS AND METHODS: Forty nine symptomatic BPH patients were evaluated prior to and at 3 months after the administration of recommended dose of doxazosin. The parameters evaluated were total symptom, storage symptom, voiding symptom and bother scores, peak flow rate (Qmax), post-voiding residuals (PVR) and prostate volume. The patients satisfaction to the treatment was determined by subjective responses to the questionnaires, and each response was categorized into one of the two groups; good (much improved, improved) or poor (slightly improved, no changes or getting worse). The subjective responses and the clinical parameters were compared and statistically analyzed. RESULTS: The total symptom, storage symptom, voiding symptom and bother scores decreased, and the Qmax increased significantly in all patients after doxazosin therapy. There was also significant mean posttherapeutic improvement for all individual questions. However, according to the patients subjective satisfaction for the treatment, patients with good result (23 patients) score then those with poor result group (26 patients; p<0.01). The changes of storage symptom score, Qmax, PVR and prostate volume were not significantly different in both groups. CONCLUSIONS: Doxazosin was effective in reducing symptoms and improving peak flow rates in the patients diagnosed clinically with BPH. Although the clinical parameters show significant improvements after doxazosin therapy, the patient satisfaction is more dependent on the severity of pre-treatment total and voiding symptom score. These findings suggest that pre-selecting patients prior to the initiation of doxazosin therapy could result in better treatment responses.
Doxazosin* ; Drug Therapy ; Humans ; Patient Satisfaction ; Patient Selection* ; Prostate ; Surveys and Questionnaires

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins

PURPOSE: The doxazosin-gastrointestinal therapeutic system (GITS) greatly minimizes the need for titration by changing the drug-delivery rate and pharmacokinetic profiles. This multi-center study was designed to evaluate the efficacy and safety of doxazosin GITS in patients with BPH when used under the standard usage conditions. MATERIALS AND METHODS: A total of 487 men, aged 40 years or over, with clinical evidence of BPH were enrolled. Demographic profiles were gathered at the baseline and the patients followed up at 4 and 8 weeks for dose adjustment and final assessment of the efficacy, respectively. The efficacy, measured in terms of the International Prostate Symptom Score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax) and post-voiding residual volume were assessed on each visit. RESULTS: On completion of the study, the mean change in the IPSS and QOL from the baseline were -6.9+/-5.7 (p<0.01) and -1.4+/-1.1 (p<0.01), respectively. The Qmax and post-voiding residual volume were significantly improved compared to the baseline (p<0.01). Decreases in the mean systolic and diastolic blood pressures from the baseline in hypertensive patients (n=139) were significantly greater than in normotensive patients (n=309). There were 25 cases (5.1%) among 487 patients in which adverse events, such as dizziness, impotence, dryness of mouth and postural hypotension, were reported. CONCLUSIONS: In treating BPH, doxazosin GITS significantly improved the IPSS, QOL, Qmax and post-voiding residual volume. Doxazosin GITS is a safe and effective drug for the treatment of BPH in Korean men when used in a standard clinical setting.
Dizziness ; Doxazosin* ; Erectile Dysfunction ; Humans ; Hypotension, Orthostatic ; Male ; Mouth ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Residual Volume

Purpose: This study aimed at evaluating the expected additive blood pressure (BP) lowering effect of vardenafil when administered in the background of chronic alpha1-blocker therapy. Materials and Methods: Patients (n=90) with symptomatic benign prostatic hypertrophy (BPH) and erectile dysfunction (ED) took vardenafil 20mg in the morning following repeated doxazosin gastrointestinal therapeutic system (GITS) 4mg (n=60) or tamsulosin 0.2mg (n=30) HS a day for 30 days. The standing and sitting BP at baseline, before taking the vardenafil and 30 minutes and 1 hour post vardenafil were measured 3 consecutive times. The data were analyzed by Student's t-test (paired), repeated measures of two-way ANOVA, chi-square tests and Pearson correlation analysis. Results: Doxazosin produced a significant reduction in systolic/diastolic BP ( 12.3/ 6.7mmHg), but tamsulosin did not. In the doxazosin group, the average reductions in BP from baseline ( 24.7/ 15.8mmHg) were significantly higher than that for the tamsulosin group ( 14.6/ 7.5mmHg). However, the average BP change was not different in both group ( 12.4/ 9.1mmHg in the doxazosin group and 11.3/ 6.4mmHg in the tamsulosin group) following a single dose of 20mg vardenafil. The higher the BP was at baseline, the more the reduction in BP was in both the doxazosin and tamsulosin groups. Two patients of tamsulosin showed a sitting systolic BP <85mmHg, but they didn't experience dizziness. Conclusions: We recommend starting Vardenafil treatment in the background of chronic aalpha1 blocker therapy, including tamsulosin, with a low dose and to increase the dose by monitoring the BP, particularly for the patients with hypertension.
Blood Pressure* ; Dizziness ; Doxazosin* ; Drug Interactions* ; Erectile Dysfunction* ; Humans ; Hypertension ; Male ; Prostatic Hyperplasia* ; Vardenafil Dihydrochloride