Comparison of the Efficacy of Isosorbide Mononitrate and Doxazosin in the Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia: A Randomized Clinical Trial

Objective: We aimed to compare the efficacy of isosorbide mononitrate and doxazosin in the treatment of lower urinary tract symptoms (LUTS). Patients and Methods: 80 patients with LUTS were included in this randomized clinical study. All patients were evaluated with uroflowmetry, post-void residual (PVR) urine, prostate volume, International Prostate Symptom Score (IPSS), serum PSA, urinalysis and culture. 40 patients were prescribed doxazosin for 4 weeks, another 40 were prescribed isosorbide mononitrate for 4 weeks. Urologic re-evaluation was done at the end of the study. Results: 74 patients completed the study. The mean age of patients was 59.6 0.7 years, the mean PSA value was 1.7 +/- 0.1 ng/ml and the mean prostate volume was 41.9 +/- 1.7 ml. Doxazosin markedly improved IPSS (from 16.2 +/- 0.7 to 9.5 +/- 0.5), maximum urinary flow rate (from 10.9 +/- 0.7 to 12.8 +/- 0.6 ml/s) and PVR urine (from 68.1 +/- 9.4 to 39.0 +/- 4.4 ml) (p < 0.0001, p < 0.0001, p = 0.0004, respectively). Isosorbide only improved IPSS (from 16.5 +/- 0.9 to 14.6 +/- 0.8) (p = 0.032). Conclusions: Daily administration of isosorbide does not seem to be an alternative to a-blocker therapy. Controlled, randomized novel studies are required to establish that whether nitric oxide donors are an effective alternative in LUTS treatment. (C) 2014 S. Karger AG, Basel