Changes in autonomic nervous system activity after treatment with alpha-blocker in men with lower urinary tract symptoms

• Published in: Investigative and clinical urology Vol. 59; no. 1; pp. 49 - 54
• Main Authors: Shim, Kang Hee, Kim, Tae Woo, Chung, Byung Ha, Lee, Sung Won, Park, Jong Kwan, Park, Kwangsung, Cheon, Jun, Lee, Kyung Seop, Kim, Hyung-Jee, Seong, Do-Hwan, Oh, Seung-June, Kim, Sae Woong, Lee, Ji Youl, Choo, Seol Ho, Choi, Jong Bo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Urological Association 01.01.2018; Korean Urological Association; 대한비뇨의학회
• Subjects: Adrenergic alpha-Antagonists - pharmacology; Adrenergic alpha-Antagonists - therapeutic use; Aged; Autonomic nervous system; Autonomic Nervous System - drug effects; Autonomic Nervous System - physiopathology; Heart Rate - drug effects; Heart Rate - physiology; Humans; Lower Urinary Tract Symptoms - drug therapy; Lower Urinary Tract Symptoms - physiopathology; Male; Middle Aged; Original; Prostate; Quinazolines - pharmacology; Quinazolines - therapeutic use; Urination; Urination - drug effects; Urination - physiology; Urodynamics - drug effects; Urological Agents - pharmacology; Urological Agents - therapeutic use; 비뇨기과학; Urination; Autonomic nervous system; Prostate
• ISSN: 2466-0493; 2466-054X; 2466-054X
• DOI: 10.4111/icu.2018.59.1.49

To determine changes in autonomic nervous system activity after treatment in men with lower urinary tract symptoms (LUTS), we evaluated changes in patients' symptoms, uroflowmetry, and heart rate variability (HRV) after treatment with alpha-blockers for 12 weeks. Ninety-five men who had LUTS (International Prostate Symptom Score [IPSS] ≥8) were included in this study. We divided them into two groups on the basis of a low frequency/high frequency (LF/HF) ratio of 1.6. After treatment with Xatral XL (Handok Inc., Korea) 10 mg for 3 months, we rechecked their IPSS, uroflowmetry, HRV and compared these with the baseline measurements. Fifty-four men were assigned to the low LF/HF group (group A: LF/HF ≤1.6) and 41 men to the high LF/HF group (group B: LF/HF >1.6). At baseline and 12 weeks, none of the parameters differed significantly between the groups except for HF, which is one of the parameters of HRV. IPSS, the IPSS-voiding subscore, and the IPSS-storage subscore decreased and maximal uroflow increased significantly after 12 weeks of treatment. Whereas the baseline LF/HF ratio increased from 0.89±0.407 to 1.80±1.804 after treatment in group A, it decreased from 3.93±5.471 to 1.79±1.153 in group B. The efficacies of Xatral XL were clear in both groups. We found that the LF/HF ratio in the two groups merged to a value of approximately 1.79 after treatment. We suggest that this could be a clue to the importance of balance in autonomic nervous system activity in men with LUTS.