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Studies have shown that 5–15% of people who are 20–50 years old, 20–30% of people who are 50–70 years old, and 10–50% of people 70+ years old urinate at least twice a night. [3] Nocturia becomes more common with age. More than 50 percent of men and women over the age of 60 have been measured to have nocturia in many communities.
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. [1] Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. [1]
The risk of postoperative urinary retention increases up to 2.11 fold for people older than 60 years. [6] Medications: Anticholinergics and medications with anticholinergic properties, alpha-adrenergic agonists, opiates, nonsteroidal anti-inflammatories (NSAIDs), calcium-channel blockers and beta-adrenergic agonists, may increase the risk. [2] [6]
Prazosin was a much better tolerated drug than phenoxybenzamine but the problem still remained that it lowered the blood pressure more than desired for a BPH treatment. [2] [8] Terazosin was the first long-lasting alpha 1 blocker approved by FDA to treat BPH. Doxazosin and Tamsulosin were approved after.
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Patients who need alpha blockers for BPH, but have a history of hypotension or postural heart failure, should use these drugs with caution, as it may result in an even greater decrease in blood pressure or make heart failure even worse. [35] [36] The most compelling contraindication is urinary incontinence and overall fluid retention.