Efficacy and safety of tamsulosin for the treatment of non-neurogenic voiding dysfunction in females: a 8-week prospective study

Abstract

We evaluated the therapeutic effects of tamsulosin for women with non-neurogenic voiding dysfunction. Women who had voiding dysfunctions for at least 3 months were included. Inclusion criteria were age > or =18 yr, International Prostate Symptom Score (IPSS) of > or =15, and maximum flow rate (Q(max)) of > or =12 mL/sec and/or postvoid residuals (PVR) of > or =150 mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram as having no or mild obstruction (group A) or moderate or severe obstruction (group B). After 8 weeks of treatment, treatment outcomes and adverse effects were evaluated. One hundred and six patients were evaluable (70 in group A, 36 in group B). After treatments, mean IPSS, bother scores, Q(max), PVR, diurnal and nocturnal micturition frequencies and scored form of the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS-SF) were changed significantly. Eighty-nine patients (84%) reported that the treatment was beneficial. The proportion of patients reported that their bladder symptoms caused "moderate to many severe problems" were significantly decreased. No significant difference were observed between the groups in terms of IPSS, bother score, Q(max), PVR, micturition frequency, and BFLUTS-SF changes. Adverse effects related to medication were dizziness (n=3), de novo stress urinary incontinence (SUI) (n=3), aggravation of underlying SUI (n=1), fatigue (n=1). Tamsulosin was found to be effective in female patients with voiding dysfunction regardless of obstruction grade.

Keywords: Adrenergic alpha-Antagonists; Female; Outcomes Assessment; Urination Disorders.

Fig. 1

Classification of the study subjects using a bladder outlet obstruction nomogram as devised by Blaivas and Groutz; Group A-no obstruction or mild obstruction, Group B-moderate obstruction or severe obstruction. Pdet_max, maximum detrusor pressure; FreeQ_max, maximum flow rate without catheter insertion.

Fig. 2

Comparisons of changes in clinical parameters-IPSS (A), Q_max, PVR (B), micturition frequency, FBC (C), BFLUTS-SF (D)-pre- vs. post-treatment. Values are adjusted using baseline values as covariates. White bars represent group A and black bars group B. P, group comparisons of improvement rates after treatment. IPSS, International Prostate Symptom Score; Q_max, maximum flow rate; PVR, postvoid residual; FBC, functional bladder capacity; QoL, quality of life.

Fig. 3

Proportion of patients by the patient's perception of bladder condition-pre- vs. post-treatment. White bars include no problems at all, some very minor problems, and some minor problems. Black bars include (some) moderate problems, severe problems, and many severe problems.

Fig. 4

Proportion of patients by the patient's perception of treatment benefit-pre- vs. post-treatment.