Long-Term Efficacy of Tamsulosin in the Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in Real-Life Practice
ABSTRACT
Background: α1-Adrenoceptor antagonists are recommended as the main pharmacological treatment for lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH/LUTS). Short-term efficacy of tamsulosin has been verified in many randomized controlled trials. However, there is a relative paucity of long-term data on the maintenance of the efficacy of this drug.
Objective: To evaluate the long-term efficacy of tamsulosin for patients with BPH/LUTS in real-life clinical practice.
Methods: A total of 113 males with BPH/LUTS (mean age {SD} = 68.5 {8.8} years; mean prostate volume {SD} = 34.2 {15.7} ml) who were treated with tamsulosin (0.2 mg daily) for more than 3 months were retrospectively evaluated. The International Prostate Symptom Score (I-PSS), quality of life (QOL) score, average and maximum flow rate (Qave and Qmax), and postvoid residual urine volume (PVR) and percentage of residual urine (%PVR) were determined before (baseline) and after the initiation of treatment.
Results: Of these patients, 72 (64%) remained on tamsulosin (12 to 48 months of treatment) and 41 (36%) withdrew after a mean of 17.4 months on average. Reasons for withdrawal were: satisfied with the current condition in 1 patient (1%), lost to follow-up for unknown reasons in 18 (16%), detection of prostate cancer in 5 (4%), insufficient therapeutic response in 16 (14%; 1 patient stopped medication; 6 changed to other drugs; 9 underwent surgery), and adverse effects (headache) in 1 patient (1%). The mean total I-PSS, total I-PSS storage subscore, total I-PSS voiding subscore, post-micturition score, and QOL score were all significantly decreased with P values of < 0.0001 after 1 month and remained stable for up to 48 months of treatment. Qave and Qmax were significantly increased (P < 0.0001), and PVR and %PVR were significantly decreased (P = 0.0051 and P = 0.0001, respectively) after 3-month treatment. The means of these scores did not change significantly, but rather appeared to remain stable for 24 to 48 months.
Conclusion: Effects of tamsulosin on BPH/LUTS are immediate (within 1 month) and persist (for over 12 months). Tamsulosin is well tolerated for BPH/LUTS.
Keywords: Alpha-blocker, Benign prostatic hyperplasia, Lower urinary tract symptoms, Tamsulosin, Pharmacotherapy
Correspondence: Tomonori Yamanishi, Department of Urology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan,
To Cite this Article: Yamanishi T, Tatssumiya K, Furuya N, Masuda A, Kamai T, Sakakibara R, Uchiyama T, Yoshida KI. Long-Term Efficacy of Tamsulosin in the Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in Real-Life Practice. UIJ. In Press. doi:10.3834/uij.1944-5784.2009.02.01