Korean J Urol.  2006 Jan;47(1):1-6. 10.4111/kju.2006.47.1.1.

The Role of Alpha 1 (A) Adrenoceptor Antagonist Tamsulosin for the Treatment of Patients with Benign Prostatic Hyperplasia: The Effect on Lower Urinary Tract Symptoms and Nocturia

Affiliations
  • 1Department of Urology, Chonbuk National University Medical School, Jeonju, Korea.
  • 2Department of Urology, Keimyng University College of Medicine, Daegu, Korea.
  • 3Department of Urology, Korea University College of Medicine, Seoul, Korea.
  • 4Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Urology, Ulsan University College of Medicine, Seoul, Korea. cskim@amc.seoul.kr

Abstract

PURPOSE: Nocturia is considered to be the main cause of disturbance of sleep maintenance and the quality of life for elderly men. We assessed the effectiveness of administering alpha 1 (A)-adrenoceptor antagonist tamsulosin for the patients with benign prostatic hyperplasia (BPH), and we measured the degree of improvement of the lower urinary tract symptoms and nocturia after treatment.
MATERIALS AND METHODS
From May 2003 to October 2003, 268 patients with BPH were prospectively selected for this study. The patients were treated with tamsulosin at a dose of 0.2mg/day. The effectiveness of tamsulosin was assessed by analyzing the three day voiding diaries and the other parameters, including the International Prostatic Symptom Score (I-PSS), the Bother score, the maximal urinary flow rate (Qmax), and the postvoid residual urine. The data for these parameters were acquired at baseline and after 4 and 12 weeks of treatment. We investigated the differences in the improvement of noctuia in the BPH patients according to the type of nocturia.
RESULTS
Of the 268 patients, 189 patients (70.5%) completed the study. The clinical parameters, including the I-PSS, the Bother score, the Qmax and the residual urine showed significant improvement from the baseline. The change of nocturnal frequency was 2.2 at baseline to 1.4 after 12 weeks of treatment. For the subgroups according to the type of nocturia, both the BPH only group and the nocturnal polyuria group showed improvement in the nocturnal frequency and the nocturnal urine volume.
CONCLUSIONS
Alpha 1 (A) adrenoceptor antagonist, tamsulosin, significantly improved the nocturia as well as the lower urinary tract symptoms, which was confirmed by measuring the clinical parameters. To identify the role of tamsulosin for improving nocturia for patients with BPH, we need to prospective clinical studies according to the type of nocturia.

Keyword

Tamsulosin; Nocturia; Quality of life

MeSH Terms

Aged
Humans
Lower Urinary Tract Symptoms*
Male
Nocturia*
Polyuria
Prospective Studies
Prostatic Hyperplasia*
Quality of Life

Cited by  1 articles

Study on Persistent Nocturia after Treatment of Benign Prostatic Hyperplasia and Effectiveness of Desmopressin in Persistent Nocturia with Nocturnal Polyuria
Jae Young Jong, Joung Hwan Son
Korean J Urol. 2008;49(10):899-905.    doi: 10.4111/kju.2008.49.10.899.


Reference

1. Bruskewitz RC, Larsen EH, Madsen PO, Dorflinger T. 3-year follow-up of urinary symptoms after transurethral resection of the prostate. J Urol. 1986. 136:613–615.
2. Weiss JP, Blaivas JG, Stember DS, Chaikin DC, Brooks MM. Evaluation of the etiology of nocturia in men: the nocturia and nocturnal bladder capacity indices. Neurourol Urodyn. 1999. 18:559–565.
3. Weiss JP, Blaivas JG, Stember DS. Nocturia in adults: etiology and classification. Neurourol Urodyn. 1998. 17:467–472.
4. Middelkoop HA, Smilde-van den Doel DA, Neven AK, Kamphuisen HA, Springer CP. Subjective sleep characteristics of 1,485 males and females aged 50-93: effects of sex and age, and factors related to self-evaluated quality of sleep. J Gerontol A Biol Sci Med Sci. 1996. 51:M108–M115.
5. Blanker MH, Groeneveld FP, Prins A, Bernsen RM, Bohnen AM, Bosch JL. Strong effects of definition and nonresponse bias on prevalence rates of clinical benign prostatic hyperplasia: the Krimpen study of male urogenital tract problems and general health status. BJU Int. 2000. 85:665–671.
6. Britton JP, Dowell AC, Whelan P. Prevalence of urinary symptoms in men aged over 60. Br J Urol. 1990. 66:175–176.
7. Yu HJ, Chen J, Lai MK, Chan KA, Chie WC. High prevalence of voiding symptoms in Taiwanese women. Br J Urol. 1998. 82:520–523.
8. Fultz NH, Herzog AR. Epidemiology of urinary symptoms in the geriatric population. Urol Clin North Am. 1996. 23:1–10.
9. Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ, et al. The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol. 1993. 150:85–89.
10. Pressman MR, Figueroa WG, Kendrick-Mohamed J, Greenspon LW, Peterson DD. Nocturia. A rarely recognized symptom of sleep apnea and other occult sleep disorders. Arch Intern Med. 1996. 156:545–550.
11. Asplund R, Aberg H. Diurnal variation in the levels of antidiuretic hormone in the elderly. J Intern Med. 1991. 229:131–134.
12. Wilt TJ, MacDonald R, Nelson D. Tamsulosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. J Urol. 2002. 167:177–183.
13. Lepor H. Tamsulosin Investigator Group. Phase III multicenter placebo-controlled study of tamsulosin in benign prostatic hyperplasia. Urology. 1998. 51:892–900.
14. Ichioka K, Ohara H, Terada N, Matsui Y, Yoshimura K, Terai A, et al. Long-term treatement of tamsulosin for benign prostatic hyperplasia. Int J Urol. 2004. 11:870–875.
15. Homma Y, Yamaguchi T, Kondo Y, Horie S, Takahashi S, Kitamura T. Significance of nocturia in the International Prostate Symptom Score for benign prostatic hyperplasia. J Urol. 2002. 167:172–176.
16. Yoshimura K, Ohara H, Ichioka K, Terada N, Matsui Y, Terai A, et al. Nocturia and benign prostatic hyperplasia. Urology. 2003. 61:786–790.
17. Kim ET, Lee SI, Lee KS. The etiology and classification of nocturia in adults. Korean J Urol. 2001. 42:1075–1079.
18. Weiss JP, Blaivas JG. Nocturia. J Urol. 2000. 163:5–12.
19. Mattiasson A, Abrams P, Van Kerrebroeck P, Walter S, Weiss J. Efficacy of desmopression in the treatment of nocturia: a double-blind placebo-controlled study in men. BJU Int. 2002. 89:855–862.
20. Nam SG, Moon DG, Kim JJ. Efficacy of desmopressin in treatment of adult nocturia. Korean J Urol. 2004. 45:49–55.
21. Lee DH, Kim JC, Suh HJ, Kim HW, Hwang TK. The effect of desmopressin in nocturia. Korean J Urol. 1999. 40:613–616.
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr