Comparison of the First Dose and Efficacy of Alfuzosin, Tamsulosin and Silodosin in the Treatment of Benign Prostatic Hyperplasia

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BACKGROUND: Alpha blockers (ARBs) are important agents in treating benign prostatic hyperplasia (BPH). Although multiple ARBs are available, comparative data on their early and mid-term effects are limited. This study aimed to evaluate and compare the early clinical efficacy of three ARBs (alfuzosin, tamsulosin and silodosin) in patients with lower urinary tract symptoms due to BPH. METHODS: This retrospective study was conducted using a 1:1:1 matched design on the basis of age, prostate-specific antigen level and prostate volume. Eligible patients were subsequently grouped for comparison. Patients received 10 mg of alfuzosin, 0.4 mg of tamsulosin or 8 mg of silodosin once daily for 3 months. Uroflowmetry parameters, including maximum urinary flow rate (Qmax), average urinary flow rate (Qave) and post-void residual volume (PVR), were assessed at baseline, 6 h after the first dose and at the first and third months. The International Prostate Symptom Score (IPSS) and quality of life (QoL) scores were evaluated at baseline and the first and third months. Repeated-measure analysis of variance (ANOVA) and Bonferroni post-hoc tests were applied. RESULTS: > 0.05). CONCLUSIONS: Silodosin provided the most rapid symptomatic improvement following initial administration, likely due to its high α1A-receptor selectivity. However, by the third month, all three agents showed similar clinical efficacy, supporting their use as viable treatment options tailored to patient-specific needs.