Abstract

Introduction: The expense and complications associated with surgical treatment of benign prostatic hyperplasia (BPH) have led to a search for safe and effective medical therapies. There has been great interest in the effect of alpha-1 adrenoreceptor antagonists in the treatment of BPH. Tamsulosin is an effective and safe alpha-1A adrenoreceptor subtype antagonist that improves lower urinary tract symptoms and uroflowmetry parameters.

In this study, we investigated whether the early effect of tamsulosin can predict the late outcome or not.

Materials and Methods: Between June 2002 and March 2003, 49 BPH patients with a mean age of 58.4±9.6, whose I-PSS 10 and above, Qmax. <15ml/sec and post voiding residual urine volume were less than 300 ml were studied. I-PSS questionnaire, PSA measurement and uroflowmetry (MMS Libra Plus®) were carried out before the treatment. Tamsulosin was given 0.4 mg/day to all the patients. In the first 24 hours after the first dose and after a week, a modified I-PSS and uroflowmetry were applied. At the 3rd month PSA measurement were added. During the study blood pressure was measured regularly. A 20% decrease in I-PSS at the 3rd month was accepted as subjective improvement, whereas a 20% increase for Qmax was accepted as objective improvement. Subjective and objective improvements together were considered as full success on the contrary if two improvements were not formed together it was accepted as unsuccessful.

Results: Objective improvement was observed in 7 (14.3%) patients, subjective improvement was observed in 13 (26.5%) patients, 22 (44.9%) patients were in full success group, 7 (14.3%) patients were in unsuccessful group. In full success group, compared between early period and pre-treatment period, objective and subjective improvements were statistically significant (p=0.000), in contrast to this, in unsuccessful group statistically significant differences were not detected between early period and pre-treatment period, objective and subjective improvements. Mean blood pressures were 141±6 & 84±3,2 and 139±4,4 & 83±2,9 at the pre-treatment period and the 3rd month of the tamsulosin therapy respectively (p=0.104). Mean PSA values were 1.2±0.7 and 1.7±1.3 ng/ml at the pre-treatment period and the 3 rd month of the tamsulosin therapy respectively (p=0.575).

Conclusion: Although the number of the patients were low, these results showed that if the modified I-PSS questionnaire and uroflowmetry were performed to the patient in the first week of the treatment it would be informative whether the patient would benefit from the tamsulosin therapy or not.

We conclude that the early effect of tamsulosin can predict the late outcome.