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Pharmacology of α1-adrenoceptor antagonists in the lower urinary tract and central nervous system

Nature Clinical Practice Urology volume 4, pages 368–378 (2007)Cite this article

Abstract

The main use of α1-adrenoceptor (AR) antagonists in urology has been to treat lower urinary tract symptoms (LUTS) in men with benign prostatic obstruction (BPO). The beneficial effects of these agents are primarily assumed to be because of relaxation of prostatic and urethral smooth muscle. The weak correlation between LUTS and prostatic enlargement, outflow obstruction, or both, however, has refocused interest on the role of extraprostatic α-ARs in the pathogenesis of LUTS and their treatment. The α1-ARs present in the bladder, urethra, vas deferens, peripheral ganglia, nerve terminals, and in the central nervous system could all potentially influence LUTS and, when the receptors are blocked, contribute to both the therapeutic and adverse effects of α1-AR antagonists. The relevance of α1-AR-subtype selectivity on the clinical usefulness of existing drug therapies has not been firmly established but it seems that blockade of both α1A/L- and α1D-ARs is necessary for the optimum balance between clinical efficacy and adverse effects.

Key Points

  • The efficacy of α1-adrenoceptor (AR) antagonists seems to be dependent on blockade of both prostatic/urethral and extraprostatic (bladder, central nervous system) α1-ARs

  • The subtypes of α1-ARs that mediate lower urinary tract symptoms have not been definitely established, but α1-AR antagonists blocking both α1L-ARs and α1D-ARs might produce the most favorable balance between efficacy and adverse effects

  • The clinically most important adverse effects of α1-AR antagonists are cardiovascular/central nervous system effects (hypotension, dizziness, sedation), abnormal ejaculation, and intraoperative floppy iris syndrome

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References

  1. Mitterberger M et al. (2007) Persistent detrusor overactivity after transurethral resection of the prostate is associated with reduced perfusion of the urinary bladder. BJU Int 99: 831–835

    Article  PubMed  Google Scholar 

  2. Andersson KE (2003) Storage and voiding symptoms: pathophysiologic aspects. Urology 62 (Suppl 2): 3–10

    Article  PubMed  Google Scholar 

  3. Jardin A et al. (1998) Alpha-blockers in the treatment of BPH. In 4th International Consultation on Benign Prostatic Hyperplasia (BPH), 599–632 (Eds Denis L et al.). Plymouth: Health Publication Ltd

    Google Scholar 

  4. Rossi C et al. (2001) Alpha-blockade improves symptoms suggestive of bladder outlet obstruction but fails to relieve it. J Urol 165: 38–41

    Article  CAS  PubMed  Google Scholar 

  5. Kessler TM et al. (2006) The effect of terazosin on functional bladder outlet obstruction in women: a pilot study. J Urol 176: 1487–1492

    Article  CAS  PubMed  Google Scholar 

  6. Chapple CR and Roehrborn CG (2006) A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol 49: 651–688

    Article  PubMed  Google Scholar 

  7. Roehrborn CG and Schwinn DA (2004) Alpha1-adrenergic receptors and their inhibitors in lower urinary tract symptoms and benign prostatic hyperplasia. J Urol 171: 1029–1035

    Article  CAS  PubMed  Google Scholar 

  8. Michel MC and Vrydag W (2006) Alpha1-, alpha2- and beta-adrenoceptors in the urinary bladder, urethra and prostate. Br J Pharmacol 147 (Suppl 2): S88–S119

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Hampel C et al. (2002) Modulation of bladder alpha1-adrenergic receptor subtype expression by bladder outlet obstruction. J Urol 167: 1513–1521

    Article  CAS  PubMed  Google Scholar 

  10. Nomiya M and Yamaguchi O (2003) A quantitative analysis of mRNA expression of alpha 1 and beta-adrenoceptor subtypes and their functional roles in human normal and obstructed bladders. J Urol 170: 649–653

    Article  CAS  PubMed  Google Scholar 

  11. Bouchelouche K et al. (2005) Increased contractile response to phenylephrine in detrusor of patients with bladder outlet obstruction: effect of the alpha1A and alpha1D-adrenergic receptor antagonist tamsulosin. J Urol 173: 657–661

    Article  CAS  PubMed  Google Scholar 

  12. Ohtake A et al. (2006) Effect of tamsulosin on spontaneous bladder contraction in conscious rats with bladder outlet obstruction: comparison with effect on intraurethral pressure. Eur J Pharmacol 545: 185–191

    Article  CAS  PubMed  Google Scholar 

  13. Tatemichi S et al. (2006) A selective alpha1A-adrenoceptor antagonist inhibits detrusor overactivity in a rat model of benign prostatic hyperplasia. J Urol 176: 1236–1241

    Article  CAS  PubMed  Google Scholar 

  14. Malloy BJ et al. (1998) Alpha1-adrenergic receptor subtypes in human detrusor. J Urol 160: 937–943

    Article  CAS  PubMed  Google Scholar 

  15. Berger AP et al. (2003) Increased growth factor production in a human prostatic stromal cell culture model caused by hypoxia. Prostate 57: 57–65

    Article  CAS  PubMed  Google Scholar 

  16. Das AK et al. (2002) Effect of doxazosin on rat urinary bladder function after partial outlet obstruction. Neurourol Urodyn 21: 160–166

    Article  CAS  PubMed  Google Scholar 

  17. Somogyi GT et al. (1995) Prejunctional facilitatory alpha 1-adrenoceptors in the rat urinary bladder. Br J Pharmacol 114: 1710–1716

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Szell EA et al. (2000) Smooth muscle and parasympathetic nerve terminals in the rat urinary bladder have different subtypes of alpha(1) adrenoceptors. Br J Pharmacol 130: 1685–1691

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Trevisani M et al. (2007) The influence of alpha(1)-adrenoreceptors on neuropeptide release from primary sensory neurons of the lower urinary tract. Eur Urol [doi:10.1016/j.eururo.2007.01.016]

    Article  CAS  PubMed  Google Scholar 

  20. Birder LA and de Groat WC (2007) Mechanisms of disease: involvement of the urothelium in bladder dysfunction. Nat Clin Pract Urol 4: 46–54

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ishihama H et al. (2006) Activation of alpha1D adrenergic receptors in the rat urothelium facilitates the micturition reflex. J Urol 175: 358–364

    Article  CAS  PubMed  Google Scholar 

  22. Furuya S et al. (1982) Alpha-adrenergic activity and urethral pressure in prostatic zone in benign prostatic hypertrophy. J Urol 128: 836–839

    Article  CAS  PubMed  Google Scholar 

  23. Appell RA et al. (1980) The effects of epidural anesthesia on the urethral closure pressure profile in patients with prostatic enlargement. J Urol 124: 410–411

    Article  CAS  PubMed  Google Scholar 

  24. Andersson KE (2002) Alpha-adrenoceptors and benign prostatic hyperplasia: basic principles for treatment with alpha-adrenoceptor antagonists. World J Urol 19: 390–396

    Article  CAS  PubMed  Google Scholar 

  25. Brading AF et al. (1999) α1-Adrenoceptors in urethral function. Eur Urol 36 (Suppl 1): 74–79

    Article  CAS  PubMed  Google Scholar 

  26. Nasu K et al. (1998) Quantification and distribution of alpha1-adrenoceptor subtype mRNAs in human proximal urethra. Br J Pharmacol 123: 1289–1293

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Taki N et al. (1999) Evidence for predominant mediation of alpha1-adrenoceptor in the tonus of entire urethra of women. J Urol 162: 1829–1832

    Article  CAS  PubMed  Google Scholar 

  28. Daniels DV et al. (1999) Human cloned alpha1A-adrenoceptor isoforms display alpha1L-adrenoceptor pharmacology in functional studies. Eur J Pharmacol 370: 337–343

    Article  CAS  PubMed  Google Scholar 

  29. Fukasawa R et al. (1998) The alpha1L-adrenoceptor subtype in the lower urinary tract: a comparison of human urethra and prostate. Br J Urol 82: 733–737

    Article  CAS  PubMed  Google Scholar 

  30. Lepor H and Theune C (1995) Randomized double-blind study comparing the efficacy of terazosin versus placebo in women with prostatism-like symptoms. J Urol 154: 116–118

    Article  CAS  PubMed  Google Scholar 

  31. Nasu K et al. (1996) Quantification and distribution of alpha 1-adrenoceptor subtype mRNAs in human prostate: comparison of benign hypertrophied tissue and non-hypertrophied tissue. Br J Pharmacol 119: 797–803

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Kurimoto S et al. (1995) Quantitative autoradiography of alpha 1 adrenoceptors with [3H]tamsulosin in human hypertrophied prostate using computerized image analysis. Histochem J 27: 1007–1013

    Article  CAS  PubMed  Google Scholar 

  33. Walden PD et al. (1999) Localization and expression of the alpha1A-1, alpha1B and alpha1D-adrenoceptors in hyperplastic and non-hyperplastic human prostate. J Urol 161: 635–640

    Article  CAS  PubMed  Google Scholar 

  34. Lepor H et al. (1993) Binding and functional properties of alpha1 adrenoceptors in different regions of the human prostate. J Urol 150: 253–256

    Article  CAS  PubMed  Google Scholar 

  35. Moriyama N et al. (1994) Multidirectional contraction of human hypertrophied prostate. Gen Pharmacol 25: 1459–1464

    Article  CAS  PubMed  Google Scholar 

  36. Morishima S et al. (2007) Identification of alpha-1L and alpha-1A adrenoceptors in human prostate by tissue segment binding. J Urol 177: 377–381

    Article  CAS  PubMed  Google Scholar 

  37. Djavan B and Marberger M (1999) A meta-analysis on the efficacy and tolerability of alpha1-adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Eur Urol 36: 1–13

    Article  CAS  PubMed  Google Scholar 

  38. Chon JK et al. (1999) Alpha 1-adrenoceptor antagonists terazosin and doxazosin induce prostate apoptosis without affecting cell proliferation in patients with benign prostatic hyperplasia. J Urol 161: 2002–2008

    Article  CAS  PubMed  Google Scholar 

  39. Tahmatzopoulos A and Kyprianou N (2004) Apoptotic impact of alpha1-blockers on prostate cancer growth: a myth or an inviting reality? Prostate 59: 91–100

    Article  CAS  PubMed  Google Scholar 

  40. Ilio KY et al. (2001) Apoptotic activity of doxazosin on prostate stroma in vitro is mediated through an autocrine expression of TGF-beta1. Prostate 48: 131–135

    Article  CAS  PubMed  Google Scholar 

  41. Garrison JB and Kyprianou N (2006) Doxazosin induces apoptosis of benign and malignant prostate cells via a death receptor-mediated pathway. Cancer Res 66: 464–472

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. McConnell JD et al. (2003) The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 349: 2387–2398

    Article  CAS  PubMed  Google Scholar 

  43. Roehrborn CG (2006) Three months' treatment with the alpha1-blocker alfuzosin does not affect total or transition zone volume of the prostate. Prostate Cancer Prostatic Dis 9: 121–125

    Article  CAS  PubMed  Google Scholar 

  44. Smith P et al. (1999) Influence of the alpha1-adrenergic antagonist, doxazosin, on noradrenaline-induced modulation of cytoskeletal proteins in cultured hyperplastic prostatic stromal cells. Prostate 38: 216–227

    Article  CAS  PubMed  Google Scholar 

  45. Boesch ST et al. (1999) Modulation of the differentiation status of cultured prostatic smooth muscle cells by an alpha1-adrenergic receptor antagonist. Prostate 39: 226–233

    Article  CAS  PubMed  Google Scholar 

  46. Brannigan RE (2004) Ejaculatory disorders and lower urinary tract symptoms. Curr Urol Rep 5: 280–286

    Article  PubMed  Google Scholar 

  47. Carbone DJ Jr and Hodges S (2003) Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life. Int J Impot Res 15: 299–306

    Article  PubMed  Google Scholar 

  48. Moriyama N et al. (1997) Quantification and distribution of alpha 1-adrenoceptor subtype mRNAs in human vas deferens: comparison with those of epididymal and pelvic portions. Br J Pharmacol 122: 1009–1014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Furukawa K et al. (1995) Alpha 1A-adrenoceptor-mediated contractile responses of the human vas deferens. Br J Pharmacol 116: 1605–1610

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Amobi N et al. (1999) Functional characterization of alpha1-adrenoceptor subtypes in longitudinal and circular muscle of human vas deferens. Eur J Pharmacol 367: 291–298

    Article  CAS  PubMed  Google Scholar 

  51. Tambaro S et al. (2005) Evaluation of tamsulosin and alfuzosin activity in the rat vas deferens: relevance to ejaculation delays. J Pharmacol Exp Ther 312: 710–717

    Article  CAS  PubMed  Google Scholar 

  52. Giuliano F et al. (2004) A comparison of the effects of tamsulosin and alfuzosin on neurally evoked increases in bladder neck and seminal vesicle pressure in rats. BJU Int 93: 605–608

    Article  CAS  PubMed  Google Scholar 

  53. Giuliano FA et al. (2006) Comparison between tamsulosin and alfuzosin on the expulsion phase of ejaculation in rats. BJU Int 98: 876–879

    Article  CAS  PubMed  Google Scholar 

  54. Domyancic AV and Morilak DA (1997) Distribution of alpha1A adrenergic receptor mRNA in the rat brain visualized by in situ hybridization. J Comp Neurol 386: 358–378

    Article  CAS  PubMed  Google Scholar 

  55. Day HE et al. (1997) Distribution of alpha 1a-, alpha 1b- and alpha 1d-adrenergic receptor mRNA in the rat brain and spinal cord. J Chem Neuroanat 13: 115–139

    Article  CAS  PubMed  Google Scholar 

  56. Thor KB and Donatucci C (2004) Central nervous system control of the lower urinary tract: new pharmacological approaches to stress urinary incontinence in women. J Urol 172: 27–33

    Article  CAS  PubMed  Google Scholar 

  57. Ishizuka O et al. (1996) Micturition in conscious rats with and without bladder outlet obstruction: role of spinal alpha 1-adrenoceptors. Br J Pharmacol 117: 962–966

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Persson K et al. (1998) Spinal and peripheral mechanisms contributing to hyperactive voiding in spontaneously hypertensive rats. Am J Physiol 275: R1366–R1373

    CAS  PubMed  Google Scholar 

  59. Yoshiyama M et al. (2000) Role of spinal alpha(1)-adrenergic mechanisms in the control of lower urinary tract in the rat. Brain Res 882: 36–44

    Article  CAS  PubMed  Google Scholar 

  60. Yoshiyama M and De Groat WC (2001) Role of spinal alpha1-adrenoceptor subtypes in the bladder reflex in anesthetized rats. Am J Physiol Regul Integr Comp Physiol 280: R1414–R1419

    Article  CAS  PubMed  Google Scholar 

  61. Sugaya K et al. (2002) Effects of intrathecal injection of tamsulosin and naftopidil, alpha-1A and -1D adrenergic receptor antagonists, on bladder activity in rats. Neurosci Lett 328: 74–76

    Article  CAS  PubMed  Google Scholar 

  62. Yokoyama O et al. (2006) Improvement of bladder storage function by alpha1-blocker depends on the suppression of C-fiber afferent activity in rats. Neurourol Urodyn 25: 461–467

    Article  CAS  PubMed  Google Scholar 

  63. Chen Q et al. (2005) Function of the lower urinary tract in mice lacking alpha1d-adrenoceptor. J Urol 174: 370–374

    Article  CAS  PubMed  Google Scholar 

  64. Mitsui T et al. (2005) Transplantation of neuronal and glial restricted precursors into contused spinal cord improves bladder and motor functions, decreases thermal hypersensitivity, and modifies intraspinal circuitry. J Neurosci 25: 9624–9636

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Blue D et al. (2002) RO700004, a selective α1A-adrenoceptor antagonist, does not improve lower urinary tract symptoms in men with benign prostatic hyperplasia [abstract]. J Urol 167 (Suppl): 265

    Google Scholar 

  66. Ikemoto I et al. (2003) Usefulness of tamsulosin hydrochloride and naftopidil in patients with urinary disturbances caused by benign prostatic hyperplasia: a comparative, randomized, two-drug crossover study. Int J Urol 10: 587–594

    Article  CAS  PubMed  Google Scholar 

  67. Gotoh M et al. (2005) Comparison of tamsulosin and naftopidil for efficacy and safety in the treatment of benign prostatic hyperplasia: a randomized controlled trial. BJU Int 96: 581–586

    Article  CAS  PubMed  Google Scholar 

  68. Nishino Y et al. (2006) Comparison of two alpha1-adrenoceptor antagonists, naftopidil and tamsulosin hydrochloride, in the treatment of lower urinary tract symptoms with benign prostatic hyperplasia: a randomized crossover study. BJU Int 97: 747–751

    Article  CAS  PubMed  Google Scholar 

  69. Kawabe K et al. (2006) Silodosin, a new alpha1A-adrenoceptor-selective antagonist for treating benign prostatic hyperplasia: results of a phase III randomized, placebo-controlled, double-blind study in Japanese men. BJU Int 98: 1019–1024

    Article  CAS  PubMed  Google Scholar 

  70. Barendrecht MM et al. (2005) Treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: the cardiovascular system. BJU Int 95 (Suppl 4): 19–28

    Article  CAS  PubMed  Google Scholar 

  71. ALLHAT Collaborative Research Group (2000) Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). JAMA 283: 1967–1975

  72. Stafford RS et al. (2004) Impact of clinical trial results on national trends in alpha-blocker prescribing, 1996–2002. JAMA 291: 54–62

    Article  CAS  PubMed  Google Scholar 

  73. Hartung R et al. (2006) Age, comorbidity and hypertensive co-medication do not affect cardiovascular tolerability of 10 mg alfuzosin once daily. J Urol 175: 624–628

    Article  CAS  PubMed  Google Scholar 

  74. Elhilali M et al. (2006) Long-term efficacy and safety of alfuzosin 10 mg once daily: a 2-year experience in 'real-life' practice. BJU Int 97: 513–519

    Article  CAS  PubMed  Google Scholar 

  75. Michel MC and Chapple CR (2006) Comparison of the cardiovascular effects of tamsulosin oral controlled absorption system (OCAS) and alfuzosin prolonged release (XL). Eur Urol 49: 501–508

    Article  CAS  PubMed  Google Scholar 

  76. Auerbach SM et al. (2004) Simultaneous administration of vardenafil and tamsulosin does not induce clinically significant hypotension in patients with benign prostatic hyperplasia. Urology 64: 998–1003

    Article  PubMed  Google Scholar 

  77. Giuliano F et al. (2006) Hemodynamic interaction study between the alpha1-blocker alfuzosin and the phosphodiesterase-5 inhibitor tadalafil in middle-aged healthy male subjects. Urology 67: 1199–1204

    Article  PubMed  Google Scholar 

  78. Chung BH and Hong SJ (2006) Long-term follow-up study to evaluate the efficacy and safety of the doxazosin gastrointestinal therapeutic system in patients with benign prostatic hyperplasia with or without concomitant hypertension. BJU Int 97: 90–95

    Article  CAS  PubMed  Google Scholar 

  79. Kirby RS (1995) Doxazosin in benign prostatic hyperplasia: effects on blood pressure and urinary flow in normotensive and hypertensive men. Urology 46: 182–186

    Article  CAS  PubMed  Google Scholar 

  80. Lowe FC (1994) Safety assessment of terazosin in the treatment of patients with symptomatic benign prostatic hyperplasia: a combined analysis. Urology 44: 46–51

    Article  CAS  PubMed  Google Scholar 

  81. Kaplan SA and D'Alisera PM (1998) Tolerability of alpha-blockade with doxazosin as a therapeutic option for symptomatic benign prostatic hyperplasia in the elderly patient: a pooled analysis of seven double-blind, placebo-controlled studies. J Gerontol A Biol Sci Med Sci 53: M201–M206

    Article  CAS  PubMed  Google Scholar 

  82. Os I and Stokke HP (1999) Effects of doxazosin in the gastrointestinal therapeutic system formulation versus doxazosin standard and placebo in mild-to-moderate hypertension. Doxazosin Investigators' Study Group. J Cardiovasc Pharmacol 33: 791–797

    Article  CAS  PubMed  Google Scholar 

  83. Buzelin JM et al. (1997) Comparison of tamsulosin with alfuzosin in the treatment of patients with lower urinary tract symptoms suggestive of bladder outlet obstruction (symptomatic benign prostatic hyperplasia). The European Tamsulosin Study Group. Br J Urol 80: 597–605

    Article  CAS  PubMed  Google Scholar 

  84. Lepor H et al. (2000) The mechanism of adverse events associated with terazosin: an analysis of the Veterans Affairs cooperative study. J Urol 163: 1134–1137

    Article  CAS  PubMed  Google Scholar 

  85. De Mey C (2000) Alpha1-blocker therapy for lower urinary tract symptoms suggestive of benign prostatic obstruction: what are the relevant differences in randomised controlled trials? Eur Urol 38 (Suppl 1): 25–39

    Article  CAS  PubMed  Google Scholar 

  86. Os I (2006) Comparison of doxazosin GITS and standard doxazosin in the treatment of high blood pressure. Int J Clin Pharmacol Ther 44: 99–106

    Article  CAS  PubMed  Google Scholar 

  87. Mottet N et al. (2003) Prostatic tissual distribution of alfuzosin in patients with benign prostatic hyperplasia following repeated oral administration. Eur Urol 44: 101–105

    Article  CAS  PubMed  Google Scholar 

  88. Becker AJ et al. (1998) Oral phentolamine as treatment for erectile dysfunction. J Urol 159: 1214–1216

    Article  CAS  PubMed  Google Scholar 

  89. Schulman C (2001) Impact of treatment of BPH on sexuality. Prostate Cancer Prostatic Dis 4: S12–S16

    Article  CAS  PubMed  Google Scholar 

  90. Hellstrom WJ and Sikka SC (2006) Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. J Urol 176: 1529–1533

    Article  CAS  PubMed  Google Scholar 

  91. Hisasue S et al. (2006) Ejaculatory disorder caused by alpha-1 adrenoceptor antagonists is not retrograde ejaculation but a loss of seminal emission. Int J Urol 13: 1311–1316

    Article  CAS  PubMed  Google Scholar 

  92. van Dijk MM et al. (2006) Effects of alpha(1)-adrenoceptor antagonists on male sexual function. Drugs 66: 287–301

    Article  CAS  PubMed  Google Scholar 

  93. Speakman M (2006) Efficacy and safety of tamsulosin OCAS. BJU Int 98 (Suppl 2): 13–17

    Article  CAS  Google Scholar 

  94. Goktas S et al. (2006) Recovery of abnormal ejaculation by intermittent tamsulosin treatment. J Urol 175: 650–652

    Article  PubMed  Google Scholar 

  95. Chang DF and Campbell JR (2005) Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg 31: 664–673

    Article  PubMed  Google Scholar 

  96. Oshika T et al. (2007) Incidence of intraoperative floppy iris syndrome in patients on either systemic or topical alpha(1)-adrenoceptor antagonist. Am J Ophthalmol 143: 150–151

    Article  PubMed  Google Scholar 

  97. Lawrentschuk N and Bylsma GW (2006) Intraoperative 'floppy iris' syndrome and its relationship to tamsulosin: a urologist's guide. BJU Int 97: 2–4

    Article  PubMed  Google Scholar 

  98. Schwinn DA and Afshari NA (2006) alpha(1)-Adrenergic receptor antagonists and the iris: new mechanistic insights into floppy iris syndrome. Surv Ophthalmol 51: 501–512

    Article  PubMed  Google Scholar 

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  1. K-E Andersson is Professor and C Gratzke (Ludwig Maximilians University, Munich, Germany) is currently Research Fellow at Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA.,

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Andersson, KE., Gratzke, C. Pharmacology of α1-adrenoceptor antagonists in the lower urinary tract and central nervous system. Nat Rev Urol 4, 368–378 (2007). https://doi.org/10.1038/ncpuro0836

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