Tamsulosin Efficiency in Treatment of Benign Prostatic Hyperplasia Evaluated by Determining Bladder Weight

Abstract

INTRODUCTION/GOAL: Bladder wall thickness and bladder mass are higher in patients with subvesical obstruction caused by benign prostate enlargement (BPE) in compensated stage of the disease. The goal of the study was to determine changes of bladder detrusor in patients suffering from benign prostatic hyperplasia (BPH) during tamsulosin treatment. The study was open, prospective and multi-centric. The material in this study was composed of 20 patients, aged > 45 years, with the present lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia, who had not been treated for the previous 3 months. The inclusive criteria also included the value of International Prostate Symptom Score (IPSS) > or = 8 points, post-void residual urine volume (PVR) < 100 ml and prostate specific antigen (PSA) < 4 ng/ml. After the end of the trials that were necessary for the introduction of the patients in the study, the patients started taking tamsulosin in a daily dosage of 0.4 mg, and the evaluation parameters during the research were measured at time intervals of 4, 12 and 24 weeks. The evaluation parameters were primary and secondary. The primary parameter included ultrasound estimated bladder weight (UEWB), while the secondary included determination of the blood pressure values (RR) and pulse frequency (PF), of total International Prostate Symptom Score (T-IPSS), a part of IPSS that related to the storage symptoms (I-PSS), a part that related to the voiding symptoms (O-IPSS), quality of life determination (IPSS-QoL), ultrasound estimation of prostate volume (VP) and the quantity of post-void residual urine volume (PVR), along with the determination of the number and strength of adverse reactions. During the introduction of the patients in the trial, the arithmetic mean of UEWB was 65 g, of PVR 43 ml, VP 35 ml, of total T-IPSS 15.6 points, of I-IPSS 6.9 points, of O-IPSS 8.7 points, and of IPSS-QoL 3.6 points. During the four-week, twelve-week and twenty-four-week checkups, the values were the following: the arithmetic mean of UEWB 36, 39 and 28 grams, of PVR 26, 29 and 21 ml, of T-IPSS 8.3, 6.4 and 5.0 points, of IPSS 3.8, 3.0 and 2.4 points, of O-IPSS 4.6, 3.4 and 2.6 points, of IPSS-QoL 1.7, 1.1 and 1.0 points and of VP 34 ml during the last control. The obtained results of this trial were processed by descriptive statistics (arithmetic mean and standard deviation) and analytical statistics by way of Student's t-test for dependant (paired) samples, with the comparison made between the obtained results with the zero checkup and four-week checkup, and subsequently the comparison between four-week and twelve-week checkup, twelve-week and twenty-four week checkup, and the zero checkup and the twenty-four week checkup. Adverse drug reactions (libido and ejaculation problems 5% and headache 5%) were mild and tolerant and did not require the interruption of the therapy. During a 24-week treatment of benign prostatic hyperplasia with tamsulosin, the same showed clinical efficiency in the sense of improvement of LUTS and a decrease of bladder outlet obstruction (BOO), without the influence on prostate volume or showing statistically significant vasodilatory effect. The same affected a significant decrease of ultrasound estimated bladder weight (from 65 g to 28 g).