Neurological status predicts response to alpha-blockers in men with voiding dysfunction and Parkinson's disease

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGOMES, Cristiano M.
dc.contributor.authorSAMMOUR, Zein M.
dc.contributor.authorBESSA JUNIOR, Jose de
dc.contributor.authorBARBOSA, Egberto R.
dc.contributor.authorLOPES, Roberto I.
dc.contributor.authorSALLEM, Flavio S.
dc.contributor.authorTRIGO-ROCHA, Flavio E.
dc.contributor.authorBRUSCHINI, Homero
dc.contributor.authorNITTI, Victor W.
dc.contributor.authorSROUGI, Miguel
dc.date.accessioned2015-07-01T20:15:59Z
dc.date.available2015-07-01T20:15:59Z
dc.date.issued2014
dc.description.abstractOBJECTIVES: To evaluate predictors of the response to doxazosin, a selective alpha-adrenoceptor antagonist, when used for the treatment of lower urinary tract symptoms in men with Parkinson's disease. METHODS: In a prospective study, 33 consecutive men (mean age 59.2 +/- 7.0 years) with Parkinson's disease and lower urinary tract symptoms were evaluated. Neurological dysfunction was assessed with the Unified Parkinson's Disease Rating Scale. Urological assessment was performed at baseline and after 12 weeks of treatment with 4 mg/day of extended-release doxazosin, including symptom evaluation with the International Continence Society male short-form questionnaire, an assessment of the impact of lower urinary tract symptoms on quality of life and urodynamics. Clinical and urodynamic predictors of response were specifically evaluated. RESULTS: Compared with the score at baseline, the total International Continence Society male short-form score was reduced after doxazosin administration, from 17.4 +/- 7.5 to 11.1 +/- 6.9 (p<0.001). The impact of lower urinary tract symptoms on quality of life was also significantly reduced, from 1.8 +/- 1.1 to 1.0 +/- 1.0 (p<0.001) and the maximum urinary flow varied from 9.3 +/- 4.4 to 11.2 +/- 4.6 ml/s (p = 0.025). The severity of neurological impairment was the only predictor of the clinical response. Additionally, patients with a Unified Parkinson's Disease Rating Scale score lower than 70 had a significantly higher chance of clinical improvement with doxazosin treatment than those with higher Unified Parkinson's Disease Rating Scale scores did (RR = 3.10, 95% CI = [1.15 to 5.37], p = 0.011). CONCLUSIONS: Doxazosin resulted in the improvement of lower urinary tract symptoms and the maximum flow rate and was well tolerated in men with Parkinson's disease. The response to treatment is dependent on the severity of neurological disability.
dc.description.indexMEDLINE
dc.identifier.citationCLINICS, v.69, n.12, p.817-822, 2014
dc.identifier.doi10.6061/clinics/2014(12)05
dc.identifier.eissn1980-5322
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/9237
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartofClinics
dc.rightsopenAccess
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.subjectLower Urinary Tract Symptoms
dc.subjectParkinson's Disease
dc.subjectUrodynamics
dc.subjectDoxazosin
dc.subject.otherbladder outlet obstruction
dc.subject.othermultiple system atrophy
dc.subject.othereau guidelines
dc.subject.othersymptoms
dc.subject.otherquestionnaire
dc.subject.otherabnormalities
dc.subject.otherreflex
dc.subject.otherrats
dc.subject.wosMedicine, General & Internal
dc.titleNeurological status predicts response to alpha-blockers in men with voiding dysfunction and Parkinson's disease
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalNITTI, Victor W.:NYU, Dept Urol, New York, NY USA
hcfmusp.citation.scopus11
hcfmusp.contributor.author-fmusphcCRISTIANO MENDES GOMES
hcfmusp.contributor.author-fmusphcZEIN MOHAMED SAMMOUR
hcfmusp.contributor.author-fmusphcJOSE DE BESSA JUNIOR
hcfmusp.contributor.author-fmusphcEGBERTO REIS BARBOSA
hcfmusp.contributor.author-fmusphcROBERTO IGLESIAS LOPES
hcfmusp.contributor.author-fmusphcFLAVIO AUGUSTO SEKEFF SALLEM
hcfmusp.contributor.author-fmusphcFLAVIO EDUARDO TRIGO ROCHA
hcfmusp.contributor.author-fmusphcHOMERO BRUSCHINI
hcfmusp.contributor.author-fmusphcMIGUEL SROUGI
hcfmusp.description.beginpage817
hcfmusp.description.endpage822
hcfmusp.description.issue12
hcfmusp.description.volume69
hcfmusp.origemWOS
hcfmusp.origem.pubmed25627993
hcfmusp.origem.scieloSCIELO:S1807-59322014001200817
hcfmusp.origem.scopus2-s2.0-84921964920
hcfmusp.origem.wosWOS:000348215800005
hcfmusp.publisher.citySAO PAULO
hcfmusp.publisher.countryBRAZIL
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