ABSTRACT

Benign prostate hyperplasia (BPH) in the leading cause of lower urinary tract symptoms (LUTS) in elderly ages. Alpha blocker treatment which is advised by urology guidelines is the main treatment of LUTS related to BPH. Alpha-1 receptor has three different subtypes including alpha-1A, alpha-1B and alpha-1D. About 98% of alpha blockers are related with prostate stromal elements and 70% of the alpha receptors are alpha-1A receptors. These receptors are responsible for contraction of prostate, bladder and urethral smooth muscles. Dizziness, fatigue, orthostatic hypotension, syncope, nasal congestion, and retrograde ejaculation are the common adverse effects of alpha blockers. Intra-operative floppy iris syndrome (IFIS), which may cause irreversible blindness, was firstly defined in patients treated with tamsulosin (an alpha-1A receptor blocker) during cataract surgery. Afterwards, it has also been shown that other alpha blockers may also cause IFIS. Pathophysiology of IFIS has not been clearly defined. This clinical picture may occur within hours after alpha blocker treatment or it may develop many years after cessation of the treatment. This paper reviews the literature and presents alpha blocker related IFIS and preventive measurements to minimalise the development of IFIS.