scholarly journals Comparative Efficacy of Tamsulosin Versus Tamsulosin Plus Finasteride in Patients with Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hypertrophy, a Randomized Open Label Parallel Group Study

2021 ◽  
Vol 14 (4) ◽  
pp. 2205-2219
Author(s):  
Cijoy Jose P ◽  
V.P. Karthik ◽  
Vasanthi Vasanthi ◽  
Punnagai guna

Background: Benign prostatic hypertrophy (BPH) is a common entity among elderly men and is responsible for significant disability. Medical treatment for BPH has played a major role in improving the symptoms associated with bladder outlet obstruction. Recent guidelines recommend the combination of an alpha-1 blocker and a 5-ARI as first-line treatment of men with moderate-to-severe LUTS. There is limited study data to support which is the effective therapy for BPH/LUTS in a tertiary care hospital in India. Methods: A randomized, open labelled, double blind, active control parallel group study comparing the safety and efficacy of tamsulosin versus tamsulosin+finasteride in subjects with lower urinary tract symptoms secondary to benign prostatic hypertrophy. The subjects were randomized after obtaining written informed consent. The subjects were recruited from the patient population that was attending the Out-Patient department of Urology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra University. Results: A total sample of 60 subjects, 30 into each group was enrolled. In the tamsulosin group, according to IPSS score, 11 patients who had moderate symptoms (36.7%) became mild, and among 19 patients who had severe symptoms (63.3%), 12 patients became mild (40%) and 7 patients became moderate (23.3%) with a p value of 0.021 which is statistically significant. In the tamsulosin+ finasteride group, according to IPSS score, 10 patients who had moderate symptoms (33.3%) became mild, and among 20 patients who had severe symptoms (66.7%), 12 patients became mild (40%) and 8 patients became moderate (26.7%) with a p value of 0.020 which is statistically significant. When comparing between the two groups, 76.7% attained mild symptoms in group 1 and 73.3% patients attained mild symptoms in group 2 with a p value of 0.766 which is statistically not significant. Conclusion: To conclude tamsulosin 0.4mg is as effective as the combination therapy of tamsulosin 0.4mg and finasteride 5mg in the treatment of lower urinary tract symptoms secondary to Benign prostatic hypertrophy.

2021 ◽  
Vol 71 (1) ◽  
pp. 45-50
Author(s):  
Muhammad Tanveer Sajid ◽  
Sami Ur Rehman ◽  
Muhammad Akmal ◽  
Hussain Ahmad ◽  
Zahoor Iqbal Mirza ◽  
...  

Objective: To compare Solifenacin versus solifenacin plus tamsulosin in terms of international prostate symptom score (IPSS) for lower urinary tract symptoms (LUTS) in patients with unilateral double-J (DJ) ureteric stents. Study Design: Comparative cross sectional study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi from Sep 2018 to Feb 2019. Methodology: A total of two hundred (n=200) patients of either gender aged 20-50 years, who underwentunilateral DJ stenting for different endourological procedures, were enrolled after satisfying inclusion/exclusioncriteria and then randomly allocated to group A (Solifenacin 5mg once daily (OD) ± placebo for 2 weeks) or group B (Solifenacin 5mg OD ± Tamsulosin 0.4 mg OD for 2 weeks) respectively. Baseline (1st post-operative day) and Post 02 weeks treatment IPSS was recorded and analyzed. Results: Mean age of presentation in group A and group B was 41.11 ± 6.45 vs 39.86 ± 5.34 years with p-value 0.14. Majority of patients in both groups were male (34% female in group A while 31% in group B, difference being statistically insignificant p 0.65). Baseline IPSS in group A and group B was 10.33 ± 2.72 vs 10.46 ± 3.12 with pvalue 0.76 (statistically insignificant) while post 02 weeks treatment IPSS in group A and B was 9.20 ± 2.67 vs 7.88 ± 2.63 respectively with p-value <0.001, the difference being statistically significant. Conclusions: Current study revealed significant advantage of combination therapy (solifenacin ± tamsulosin)compared with solifenacin monotherapy in lowering LUTS based on IPSS in patients having unilateral......


Diagnostics ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 46 ◽  
Author(s):  
Malling ◽  
Lönn ◽  
Jensen ◽  
Lindh ◽  
Frevert ◽  
...  

Nearly one in three men develop lower urinary tract symptoms (LUTS) and 10% clinically progress despite medication. Transurethral resection of the prostate (TURP) is the reference standard for symptoms refractory to medical treatment. However, some patients cannot tolerate TURP for medical (e.g., comorbidity) or technical (e.g., large prostate) reasons. This study estimated the safety and effect of prostate artery embolization (PAE) in men unfit for surgery. A prospective, single-centre trial including men with LUTS or urinary retention secondary to benign prostatic hyperplasia (BPH) who were unfit for surgery. The primary objective was to treat urinary retention and LUTS. Outcome measures included International Prostate Symptom Score (IPSS), quality of life (IPSS-QoL), International Index of Erectile Function (IIEF-5), prostate volume (PV), prostate-specific antigen (PSA), peak void flow (Qmax), post-void residual (PVR), and complications. A p-value < 0.05 was considered statistically significant. Eleven consecutive patients with a mean age of 75.2 (SD ± 8.2) underwent PAE. Catheter removal was successful in 60%. IPSS-QoL improved 4.5 points (95% CI: −5.6; −3.4), and PV was reduced by 26.2 cm3 (95% CI: −50.9; −2.3). None of the remaining outcomes changed. No major complications occurred. PAE was effective and safe for LUTS and urinary retention associated with BPH in men unfit for surgery.


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