DOUBLE-BLIND PLACEBO CONTROLLED STUDY OF Α-Adrenergic RECEPTOR ANTAGONISTS (DOXAZOSIN) FOR TREATMENT OF VOIDING DYSFUNCTION IN THE PEDIATRIC POPULATION

Abstract

Compared to placebo, doxazosin did not demonstrate a significant objective benefit, but produced a significant subjective benefit in the treatment of urinary incontinence secondary to voiding dysfunction.

The Evidence Paradox of the Effectiveness between the Paediatric and Adult Stone-Forming Population: A Narrative Review

“…The authors concluded that further studies are possible due to the favourable safety profile of tamsulosin in children with neuropathic bladder (LE: 1b). A similarly favourable side-effect profile is reported by Yucel et al [21] in their study of tamsulosin vs. biofeedback for dysfunctional voiding and urinary retention, with no drug-related side effects reported in the α-blocker group, while Kramer et al [20] did not report any side-effect results in their study (LE: 1b). All the prospective trials (LE: 2a) as well as the retrospective cohorts (LE: 2b) reported no minimal adverse effects, with the most notable reports being those observed by Yang et al [27] of negligible decreases of systolic and diastolic blood pressure and that of Austin et al [23] with one patient developing mild postural hypotension, which resolved with dose reduction (doxazosin 0.5 mg).…”

“…Four were prospective randomized studies (LE: 1b) [19][20][21][22], 6 studies were well-designed prospective cohorts without randomization (LE: 2a) [23][24][25][26][27][28], 2 studies were retrospective (LE: 2b) [29,30], while one review (LE: 3) [31] and one expert panel report (LE: 4) [32] were also found. For the adult population, 5 articles were chosen that represent the latest and highest quality of published evidence to provide for arguments in the discussion [33][34][35][36][37], including the most recent meta-analysis and the only double-blind, placebocontrolled randomized study (LE: 1a and 1b, respectively) to date.…”

Biofeedback Therapy for Dysfunctional Voiding in Children

“…α-Blockade has been shown to be highly effective when patients are selected carefully [52]. However, less discriminating use of α-blockers has shown poor results [53]. Currently, only 1% to 2% of children treated at our institution for LUTD receive α-blockers, with or without biofeedback, and only after demonstrating low flow patterns and low EMG activity.…”

Blasenschulung bei Kindern mit funktioneller Harninkontinenz

“…Auch für Tolterodin konnte kein signifikanter Effekt nachgewiesen werden [21], wobei möglicherwei-se die Studienmedikation bei älteren Kindern zu niedrig dosiert war. In einer doppelblinden Untersuchung zu Doxazosin konnte gezeigt werden, dass unter Verum im Vergleich zu Placebo die durchschnittliche Anzahl inkontinenter Episoden von 18 auf 4/Woche abnahm; der Effekt war allerdings -vermutlich aufgrund der kleinen Studienpopulation -nicht signifikant [17]. Für die Wirksubstanz Propiverin zeigte sich in einer kontrollierten Studie bei 50% der Patienten eine signifikante Reduktion inkontinenter Episoden pro Woche um mehr als 50% [5].…”