Journal List > Korean J Urol > v.50(2) > 1005271

Kim, Kim, Chung, Kwon, Park, and Ryu: Effect of Tamsulosin HCl (0.2 mg) on Female Lower Urinary Tract Symptoms with Maximal Urinary Flow Rate Less Than 12 ml/sec

Abstract

Purpose

Alpha adrenergic components do not seem prevalent in the female bladder neck. Nevertheless, some studies using alpha-blockers in women suffering from obstructed urine flow have been reported. We assessed the effectiveness of administering an alpha 1-adrenoceptor antagonist, tamsulosin, in patients with a maximal flow rate less than 12 ml/sec.

Materials and Methods

From January 2007 to December 2007, 150 patients with a maximal flow rate less than 12 ml/sec were selected for this study. Patients were treated with tamsulosin at a dose of 0.2 mg per day. The effectiveness of tamsulosin was assessed by analyzing the International Prostate Symptom Score (IPSS) and other parameters, including the maximal urinary flow rate (Qmax) and the amount of postvoid residual urine. The data for these parameters were acquired at baseline and after 4 and 12 weeks of treatment.

Results

Of the 150 patients, 113 patients (75.3%) completed the study. Except for the storage symptom score, all clinical parameters, including total IPSS, voiding symptom score, Qmax, and the amount of residual urine, showed significant improvement after 4 and 12 weeks of treatment (p<0.05). The incidence of adverse events was only 4.4%, including dizziness in 3 patients, stress incontinence in 1 patient, and lethargy in 1 patient.

Conclusions

The alpha-1 adrenoceptor antagonist tamsulosin significantly improved subjective symptoms and uroflowmetric parameters in female patients with a low maximal flow rate of less than 12 ml/sec. The use of tamsulosin may be an initial treatment option in females with a low maximal urinary flow rate.

Figures and Tables

Table 1
Patients characteristics and comorbidity
kju-50-130-i001

IPSS: International Prostate Symptom Score

Table 2
The chief complaint that patients presented
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Table 3
Comparison of the clinical parameters before and after treatment
kju-50-130-i003

IPSS: International Prostate Symptom Score, a: no significant change in maximal flow rate, residual urine between 4 weeks and 12 weeks

References

1. Abrams P. Lower urinary tract symptoms in women: who to investigate and how. Br J Urol. 1997. 80:Suppl 1. 43–48.
2. Kuo HC. Urodynamic parameters for the diagnosis of bladder outlet obstruction in women. Urol Int. 2004. 72:46–51.
3. Massey JA, Abrams PH. Obstructed voiding in the female. Br J Urol. 1988. 61:36–39.
4. Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS, Zimmern PE. Proposed cutoff values to define bladder outlet obstruction in women. Urology. 1998. 51:408–411.
5. Ek A, Alm P, Andersson KE, Persson CG. Adrenergic and cholinergic nerves of the human urethra and urinary bladder. A histochemical study. Acta Physiol Scand. 1977. 99:345–352.
6. Kumar A, Mandhani A, Gogoi S, Srivastava A. Management of functional bladder neck obstruction in women: use of alpha-blockers and pediatric resectoscope for bladder neck incision. J Urol. 1999. 162:2061–2065.
7. Im JG, Kim JC, Seo SI, Park YH, Hwang TK. Bladder outlet obstruction in female patients with lower urinary tract symptom. Korean J Urol. 2003. 44:1116–1120.
8. Clarke B. The role of urodynamic assessment in the diagnosis of lower urinary tract disorders. Int Urogynecol J Pelvic Floor Dysfunct. 1997. 8:196–199.
9. Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol. 1999. 161:1535–1540.
10. Fralick RA, Appell RA, Nitti VW. Nitti VW, editor. Urodynamics in pelvic organ prolapsed. Practical urodynamics. 1998. Philadelphia: Saunders;211–218.
11. Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn. 2000. 19:553–564.
12. Groutz A, Blaivas JG, Chaikin DC. Bladder outlet obstruction in women: definition and characteristics. Neurourol Urodyn. 2000. 19:213–220.
13. Farrar DJ, Osborne JL, Stephenson TP, Whiteside CG, Weir J, Berry J, et al. A urodynamic view of bladder outflow obstruction in the female: factors influencing the results of treatment. Br J Urol. 1975. 47:815–822.
14. Lee JH, Kim HS, Lee JY. The characteristics of voiding difficulty in women and the effect of tamsulosin. Korean J Urol. 2006. 47:1327–1333.
15. Chang HS, Park CH, Kwon TG, Kim DY, Oh TH, Jung JI, et al. Efficacy of tamsulosin 0.2 mg/day in female patients with lower urinary tract symptoms. J Korean Continence Soc. 2006. 10:140–146.
16. Pischedda A, Pirozzi Farina F, Madonia M, Cimino S, Morgia G. Use of alpha1-blockers in female functional bladder neck obstruction. Urol Int. 2005. 74:256–261.
17. Groutz A, Gordon D, Lessing JB, Wolman I, Jaffa A, David MP. Prevalence and characteristics of voiding difficulties in women: are subjective symptoms substantiated by objective urodynamic data? Urology. 1999. 54:268–272.
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Kwangsung Park
https://orcid.org/http://orcid.org/0000-0001-8827-162X

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