Alfuzosin for the treatment of storage symptoms suggestive of overactive bladder

Introduction: Antimuscarinics are the mainstay of overactive bladder (OAB) pharmacotherapy although other agents, such as alpha-adrenergic receptor antagonists, might also be effective. Alfuzosin has alpha 1-adrenoreceptor antagonist activity and is available worldwide for the treatment of lower urinary tract symptoms resulting from benign prostate hyperplasia. Alfuzosin may relieve storage symptoms suggestive of OAB in patients with or without bladder outlet obstruction (BOO). Areas covered: This paper reviews the available literature on the use of alfuzosin in the treatment of storage symptoms suggestive of OAB. Additionally, the role of alpha-adrenoreceptor antagonists in the treatment of OAB is reviewed, based on pathophysiology. Expert opinion: Although alfuzosin is effective against storage symptoms, it does not improve them in all patients with OAB. It is likely that alternative types of therapy, such as antimuscrarinics, need to be co-administered to patients with residual storage symptoms after alfuzosin administration. Alfuzosin can decrease the risk of adverse events associated with antimuscarinics. The sequential use of alfuzosin and antimuscarinics appears to be an appropriate strategy for the treatment of storage symptoms suggestive of OAB related to BOO.