Open-Label, Longitudinal Study of Tamsulosin for Functional Bladder Outlet Obstruction in Women

Abstract

Objectives: To investigate the clinical effect of tamsulosin for the treatment of functional bladder outlet obstruction (BOO) in adult women. Methods: In a prospective, longitudinal open-label study, 63 women affected by functional BOO were treated with tamsulosin. Inclusion criteria were: age >18 years, reporting voiding symptoms (intermittent stream, hesitancy, straining and/or a feeling of incomplete emptying), uroflowmetry maximum flow rate (Q_max) under 12 ml and/or presence of postvoid residual greater than 50% of the voiding volume. Exclusion criteria were: patients suffering from any other anatomical or functional disorder such as urethral stenosis, pelvic organ prolapse, neurological disturbances, or systemic diseases that could impact upon bladder voiding. Tamsulosin was administered in a single daily dose of 0.4 mg for at least 30 days. Primary outcomes were clinical efficacy and Q_max improvement; secondary outcomes were tolerability and safety. Voiding and storage symptoms and uroflowmetry results were assessed before and at the end of the α-blocker therapy. Results: Tamsulosin therapy was well tolerated. After therapy voiding symptoms improved in 71.4% of patients (45/63; p < 0.0001), and if associated with storage symptoms in 66.67% (26/39; p < 0.00001). Recurrent infections were reduced by 50% in 81% (21/26) of patients. Uroflowmetry parameters improved in 36/63 patients (57.1%). Postvoiding residue improved in 62.5% (10/16) and disappeared in 25% (4/16) with no significant changes in voided volume. An improvement was observed in 66% (16/24) of patients with isolated voiding symptoms, in 51.2% (20/39) with associated storage symptoms and in 65% (17/26) of women with associated recurrent urinary infections. Conclusions: These results suggest that α-blocker may be an effective treatment option in women with voiding dysfunction due to functional BOO.

Een α‑adrenerge receptorantagonist als behandeling van blaasontledigingsklachten bij vrouwen: Feit of fictie?

“…Er werd een significante daling gevonden van gemiddeld 5 punten [9][10][11]. Urodynamisch gezien leidde in alle prospectieve onderzoeken tamsulosine tot een significante verbetering van de Qmax met 3,3-7,1 ml/s, en in de studie waarin 1-5 mg terazosine werd gegeven zelfs met 11,1 ml/s [9][10][11][12][13][14]. De PdetQmax werd in twee prospectieve studies onderzocht en daalde in de ene studie met 10 cmH2O en in de andere studie met 20 cmH2O [13,14].…”

Overactive bladder symptoms and voiding dysfunction in neurologically normal women

“…In neurologically normal women, without an anatomical BOO such as urethral stenosis, POP etc., alpha‐blocker therapy may have some impact on voiding symptoms. In a prospective, longitudinal open‐label study, 63 women affected by functional BOO were treated with tamsulosin administered in a single daily dose of 0.4 mg for at least 30 days 38. Tamsulosin therapy was well tolerated.…”

α1‐Blockers for the treatment of recurrent urinary tract infections in women with dysfunctional voiding: A prospective randomized study

“…Constantini et al . evaluated the effect of tamsulosin on recurrent UTI; 63 women with predominant voiding symptoms and functional bladder outlet obstruction were enrolled and given tamsulosin 0.4 mg daily for at least 30 days, 65% of patients experienced improvements in urodynamic parameters (peak flow rate and PVR) and 81% of patients had a 50% reduction in recurrent UTI …”