Objectives: To prospectively evaluate the effectiveness of tamsulosin in treating women with voiding difficulty.
Methods: Female patients presenting chronic, bothersome voiding symptoms, combined with subnormal uroflow were treated with 0.2 mg tamsulosin daily for six weeks. Outcome analyses included the International Prostate Symptom Score and uroflowmetry with post-void residual urine. Patients achieving a 50% or greater reduction in their voiding symptom score, combined with a 30% or greater increment in their maximal flow rate were regarded as having a good therapeutic response. Subgroup analysis was performed in patients classified as having bladder outlet obstruction, or detrusor underactivity based on pressure-flow study, excluding those with indwelling catheterization or intermittent self-catheterization as well as those with anatomic obstruction.
Results: Ninety-seven patients met the study inclusion criteria and were enrolled. Significant improvements in voiding symptom score, storage symptom score, maximal flow rate, post-void residual urine and voiding efficiency were observed in all patients while on tamsulosin. A good therapeutic response was observed in 35.1% of patients. Of these, 33 were classified as having bladder outlet obstruction and 52 had detrusor underactivity. Although both groups experienced significant reduction in their voiding symptom scores, patients with bladder outlet obstruction were more likely to achieve a reduction of their voiding symptom score. The magnitude of improvement in uroflow parameters as well as the proportion of patients achieving a good therapeutic response (39.4% for bladder outlet obstruction vs 32.7% for detrusor underactivity, P = 0.69) were similar between the two groups. Adverse events were mild and tolerable.
Conclusions: Tamsulosin has beneficial effects in a significant proportion of women with voiding difficulty.