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Phenoxybenzamine in Benign Prostatic Obstruction-Reply

Michael J. Barry, MD
JAMA. 1988;260(15):2220. doi:10.1001/jama.1988.03410150068032.
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In Reply.—  Drs Staub and Staub report a case series of patients with symptomatic benign prostatic hyperplasia (BPH) treated in their medical practice with phenoxybenzamine and suggest that this drug may be a valuable adjunct to "watchful waiting" for these patients. They report "prompt and substantial relief of... symptoms and improved bladder emptying," usually with a dosage of 10 mg/d and few side effects.There have been three small (about 20 patients per group), short (two- to five-week) placebo-controlled randomized trials of phenoxybenzamine vs a placebo.1-3 The study by Caine et al1 found significant improvements in frequency and flow rates, but not residual volume (bladder emptying), with 20 mg/d over two weeks. Side effects occurred in 11 of 25 patients, but were not severe enough to stop therapy. Abrams et al2 found increases in flow rate and a drop in residual urine, a better overall symptom rating,


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