The Effect of Switching Patients with Symptomatic Benign Prostatic Hyperplasia from Tamsulosin 0.2 mg to 0.4 mg

Supadach Teawongsuwon, Sompol Pempongkosol

The Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

DOI: 10.4236/oju.2013.32021                

Abstract

Objectives: In 2010, tamsulosin 0.2 mg (OD) was withdrawn from Thailand and replaced with tamsulosin 0.4 mg (OD). Therefore, we assessed the impact of this change on the patients, at a men’s health clinic, with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Material and Methods: Subjects were 100 men with BPH who had been taking tamsulosin 0.2 mg as needed for at least 3 months. The outcome measures were IPSS, AMS and IEFF5 scores and uroflowmetry. Tolerability was evaluated on by adverse events. Changes from baseline were assessed using the paired t-test. SPSS version 12.0 was used for statistical analysis, with p < 0.05 considered significant. Results: The mean follow up of tamsulosin 0.2 and 0.4 mg were 20.23 and 10.56 months respectively. On switching from tamsulosin 0.2 to 0.4 mg, mean IPSS score improved from 15.54 ± SD 1.25 to 14.13 ± SD 1.09 (p = 0.034), Q max 15.91 cm³/sec ± SD 1.36 to 16.69 cm³/sec ± SD 1.52 (p = 0.128), and nocturia 3.15 ± SD 0.32 to 2.68 ± SD 0.39 (p = 0.015), respectively. However IEFF-5 score and AMS score increased from14.78 ± SD 1.38 to 15.79 ± SD 1.03 (p = 0.0055) and 34.76 ± SD 2.76 to 33.21 ± SD 2.62 (p = 0.0853), respectively. Treatment-related adverse events of Tamsulosin 0.2 mg included dizziness (4%), postural hypotension (3%) and retrograde ejaculation (3%). Interestingly, no withdrawals resulted from adverse events during Tamsulosin 0.4 mg assessment. Conclusions: Switching to tamsulosin 0.4 mg improves LUTS. The change was well tolerated by the majority of patients. Increased symptoms scores of erectile dysfunction and aging male during the study may be due to increased age.

Keywords

Tamsulosin; Benign Prostatic Hypertrophy (BPH); Lower Urinary Tract Symptoms (LUTS)

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	R. Webber, “Benign Prostatic Hyperplasia,” Clinical Evidence, Vol. 15, 2006, pp. 1213-1226.
[2]	S. J. Jacobsen, C. J. Girman, H. A. Guess, et al., “Natural History of Prostatism: Longitudinal Changes in Voiding Symptoms in Community Dwelling Men,” Journal of Urology, Vol. 155, No. 2, 1996, pp. 595-600.
[3]	M. J. Barry, F. J. Fowler, L. Bin, et al., “The Natural History of Patients with Benign,” 1997.
[4]	P. Narayan and H. S. G. R. Tunuguntla, “Long-Term Efficacy and Safety of Tamsulosin for Benign Prostatic Hyperplasia,” Review in Urology, Vol. 7, 2005, pp. 42-45.
[5]	F. C. Lowe, “Summary of Clinical Experiences with Tamsulosin for the Treatment of Benign Prostatic Hyperplasia,” Review of Urology, Vol. 7, No. 3, 2005, pp. 13-21.
[6]	J.-W. Chung, S. H. Choi, B. S. Kim, T.-H. Kim, E. S. Yoo, C. Il Kim, K. S. Lee and T. G. Kwon, “Efficacy and Tolerability of Tamsulosin 0.4 mg in Patients with Symptomatic Benign Prostatic Hyperplasia,” Korean Journal of Urology, Vol. 52, No. 7, 2011, pp. 479-484.
[7]	A. K. Erik, “Storage and Voiding Symptoms: Pathophysiologic Aspects,” Journal of Urology, Vol. 62, No. 3, 2003, pp. 3-10.
[8]	R. Sakakibara, S. Hamano, T. Uchiyama, Z. Liu, T. Yamanishi and T. Hattori, “Do BPH Patients Have Neurogenic Detrusor Dysfunction? A Uro-Neurological Assessment,” Journal of Urology, Vol. 74, No. 1, 2005, pp. 44-50.
[9]	R. Christopher, J. E. Batista, R. Berges, E. Chartier-Kastler, A. Tubaro, P. Van Kerrebroeck and H. Stoevelaar, “The Impact of Nocturia in Patients with LUTS/BPH: Need for New Recommendations,” Journal of European Urology, Vol. 5, Suppl. 5, 2006, pp. 12-18.
[10]	P. Van Kerrebroeck, “Nocturia and Tamsulosin OCAS,” Journal of European Urology, Vol. 6, 2007, pp. 695-760.
[11]	M. H. Braun, F. Sommer, G. Haupt, M. J. Mathers, B. Reifenrath and U. H. Engelmann, “Lower Urinary Tract Symptoms and Erectile Dysfunction: Co-Morbidity or Typical ‘Aging Male’ Symptoms? Results of the ‘Cologne Male Survey’,” European Urology, Vol. 44, No. 5, 2003, pp. 588-594.
[12]	R. Kumar, A. Nehra, D. J. Jacobson, M. E. McGree, N. M. Gades, M. M. Lieber, S. J. Jacobsen and J. L. St. Sauver, “Alpha-Blocker Use Is Associated with Decreased Risk of Sexual Dysfunction,” Journal of Urology, Vol. 74, No. 1, 2009, pp. 82-87.
[13]	S. Permpongkosol, S. Krilad-O-Larn and K. Ratana-OLarn, “Treatment with a Uroselective α1-Blocker Improves Voiding and Sexual Function: A Study in Thai Men with lower Urinary Tract Symptoms,” Journal of Sex Medicine, Vol. 13, No. 4, 2011, pp. 534-536.
[14]	Kristi Monson, 2007. http://www.emedtv.com/tamsulosin-side-effect.htm