Intravesical prostatic protrusion can be a predicting factor for the treatment outcome in patients with lower urinary tract symptoms due to benign prostatic obstruction treated with tamsulosin

Abstract

Objective: To assess the effect of the intravesical protrusion of the prostate (IPP) on the response to medical treatment with tamsulosin for a 3 month period.

Materials and methods: The study, which was conducted between 2009 and 2011 in the ambulatory clinic of an academic hospital, divided 183 patients with lower urinary tract symptoms due to benign prostatic obstruction in 2 groups (90 and 93 patients, respectively) according to intravesical prostatic protrusion (IPP): group A ≤10 mm; group B >10 mm. Patients were treated with tamsulosin (0.4 mg, once daily) for 3 months. The International Prostate Symptom Score (IPSS; -35% and -3 points) and maximum urinary flow (Qmax) assessed by uroflowmetry (+1.6 mL/s and +25%) response criteria were defined. Patients' responses from the 2 groups were compared.

Results: After 3 months of treatment, Qmax increased, with 2.74 mL/s (25%) in group A (P <.01) and 1.59 mL/s (19%) in group B (P = .07). IPSS decreased, with 39.9% (P < .01) and 29.7% (P = .08), respectively. Statistically significant differences were noted for IPSS -35% responders (78% group A vs 58% group B, P <.01), -3 points IPSS responders (82% vs 64%), Qmax +25% responders (82% vs 58%), and Qmax +1.6 mL/s responders (85% vs 62%, P <.01). No major adverse events occurred. The relative small number of patients enrolled was the main study limitation.

Conclusion: Men with IPP exceeding 10 mm seem to be more frequently poor responders to medical treatment with tamsulosin among patients with lower urinary tract symptoms due to benign prostatic obstruction, prostatic volume <40 mL, and prostate-specific antigen <1.5 ng/mL.