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Tamsulosin may relieve lower urinary tract symptoms in women

12 Aug 2017

Tamsulosin demonstrates efficacy in the treatment of lower urinary tract symptoms (LUTS) in women, according to a meta-analysis.

Researchers searched multiple electronic databases for randomized controlled trials (RCTs) evaluating the effect of tamsulosin on LUTS in female patients. Primary outcome measurements consisted of indicators of storage (eg, urinary urgency, frequency, urgency incontinence and nocturia) and voiding symptoms (eg, maximum urinary flow rate [Qmax], average flow rate, postvoid residual volume, urethral closure pressure and pressure at Qmax).

A total of six RCTs involving 764 patients were included in the final analysis, comprising four that compared tamsulosin with placebo, one that compared tamsulosin with prazosin, and another that compared tamsulosin with tamsulosin plus tolterodine.

Pooled data revealed that total International Prostate Symptom Score (IPSS) was better with tamsulosin vs placebo (standardized mean difference, −4.08; 95 percent CI, −5.93 to −2.23; p<0.00001). Likewise, improvements observed in IPSS (storage symptom score), IPSS (voiding symptom score) and quality of life score were greater with tamsulosin.

Additionally, the Overactive Bladder Questionnaire score was more favourable with tamsulosin vs placebo.

In terms of urodynamic parameters, tamsulosin was associated with markedly improved average flow rate and postvoid residual volume when compared with prazosin and tamsulosin plus tolterodine, respectively. No significant difference between the tamsulosin treatment and control groups were noted in other parameters.

Often overlooked and underdiagnosed in women, LUTS involve storage, voiding and postmicturition symptoms affecting the lower urinary tract. Voiding symptoms include weak or intermittent urinary stream, straining, hesitancy, terminal dribbling and incomplete emptying. Storage symptoms, on the other hand, comprise urge urinary incontinence and overactive bladder featured by urgency, frequency, urgency incontinence and nocturia. [BMJ 2010;340:c2354; Maturitas 2013;76:225–229]

LUTS can be managed by lifestyle modifications, behavioural therapy, pelvic floor muscle training, bladder training and drug therapy. Muscarinic receptor antagonists are used as first-line therapy. However, the agents have been associated with the typical anticholinergic side effects of dry mouth, somnolence, constipation and blurred vision, often resulting in poor treatment compliance. [Int Neurourol J 2010;14:201–202; Expert Rev Clin Pharmacol 2008;1:163–175]

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