Urodynamic outcomes of tamsulosin in the treatment of primary bladder neck obstruction in men.

Abstract

INTRODUCTION:

Alpha blockers are widely used in the treatment of primary bladder neck obstruction; however, evidence for objective urodynamic efficacy is scarce. We studied the effect of the uroselective α1-blocker tamsulosin on urodynamic parameters in male patients with type I primary bladder neck obstruction.

METHODS:

A single center prospective observational study was carried out from July 2013 to February 2015. Male patients (18-50 years) with type 1 primary bladder neck obstruction were recruited. Selected patients were started on tablet tamsulosin 0.4 mg once daily for 3 months. International prostate symptom score (IPSS), uroflow and urodynamic studies were done pre- and post-treatment. Primary outcome was decreased in minimum detrusor pressure at maximum flow rate by 15%. Wilcoxon-matched pair signed-rank test was used.

RESULTS:

Of 39 patients recruited, 21 patients completed the follow-up as per protocol and were analyzed. Mean age was 41 years. 57% patients achieved the primary outcome (median detrusor pressure pre- and post-treatment were 71 and 56 cm of water, P < 0.001). Similarly, median values for bladder outlet obstruction index (BOOI) and IPSS decreased from 59 to 38 (P < 0.001) and 22 to 12 (P < 0.001), respectively. Median maximum flow rate increased from 8 to 10 ml (P = 0.05). Pretreatment BOOI of >60 was associated with poor outcomes.

CONCLUSIONS:

Tamsulosin 0.4 mg once a day is effective in reducing bladder outlet obstruction on pressure flow studies in patients with primary bladder neck obstruction type 1.

• Authors: Manoj K Sudrania, Anuj Deep Dangi, Santosh Kumar, Barath Kumar, Nitin S Kekre
• Journal: Indian journal of urology : IJU : journal of the Urological Society of India (Indian J Urol) 2018 Jan-Mar Vol. 34 Issue 1 Pg. 34-38 ISSN: 0970-1591 [Print] India
• PMID: 29343910 (Publication Type: Journal Article)