Tamsulosin Can Improve Lower Urinary Tract Symptoms in Patients Under Active Surveillance Due to Low Risk Prostate Cancer: Prospective Controlled Study

Abstract

Objective:We aimed to evaluate the efficacy of tamsulosin in the treatment of lower urinary tract symptoms (LUTS) in patients under active surveillance (AS) for low-risk prostate cancer (Pca). Materials and Methods: Patients who underwent prostate biopsy between 2010 and 2014 were evaluated prospectively. Inclusion criteria for AS were PSA level below 10 ng/mL, a tumor in a maximum of two cores, a tumor core percentage below 50%, a clinical stage ≤ T2a and a Gleason score ≤6. Patients under AS with LUTS were included in the study group and patients with benign pathology results with LUTS were included in the control group. International prostate symptom score (IPSS) and uroflowmetry test were used to evaluate LUTS. The maximum flow rate (Q max ) was recorded. All patients received tamsulosin 0.4 mg once daily in a modified-release formulation (Flomax MR®, Astellas, Japan). Transurethral resection prostatectomy (TUR-P) was performed when surgical treatment was necessary for obstruction despite tamsulosin treatment. Results: The study included a total of 91 patients, 41 patients in the AS group and 50 patients in the control group. Patients were assessed after six months. There was a 30% reduction in IPSS in the AS group and 24.5% in the control group (p=0.591). Q max increased by 20.4% in the AS group and by 20% in the control group (p=0.985). The need for TUR-P was similar between the two groups (14.6% vs 20%, p=0.503) during three-year follow-up. Conclusion: Tamsulosin can be used safely and with high efficacy for LUTS in patients under AS for low-risk Pca. The improvement in IPSS and Q max , and the need for surgical treatment were similar to the control group.