TO DETERMINE THE EFFECTIVENESS OF TAMSULOSIN ON DECREASING BLADDER OUTLET OBSTRUCTION BY EVALUATING ITS INDIRECT EFFECT ON BLADDER WEIGHT

Introduction: Urinary Bladder wall thickness and weight tend to be more in patients with urinary outlet obstruction caused by BPE (Benign Prostate Enlargement) in compensated early phase of the disease. 

Aim: The purpose   of the study was to determine the effectiveness of Tamsulosin on decreasing bladder outlet obstruction by evaluating its indirect effect on bladder weight.

Materials and Methods: The material in this study was composed of 63 patients, aged more then 45, with the present lower urinary tract symptoms (LUTS) caused by benign prostatic enlargement, who had not been treated for the previous 3 months. The inclusion criteria were also the value of (IPSS) IS ≥ 8 points, PMRV (post-void residual urine volume) <100ml, (PSA) <4nanogram/ml. The enrolled patients took Cap Tamsulosin 0.4 mg once daily and the evaluation parameters during the research were measured at time intervals of 4, 12 and 24 week. The parameters for evaluations was primary and secondary. Primary parameter was the (UEWB) ultrasonic estimated bladder weight, and the secondary were assessments of IPSS score, the quality-of-life determination (IPSS -QoL), and the amount of post-voided residual volume (PMRV), as well along with the determination of the number and strength of adverse reactions.

Results: At the time of the enrollment of the patients in the study, the arithmetic means of UEWB was 55g, PMRV was 43 ml, and IPSS of 20.97, and IPSS-QoL 5 points. After 24 weeks of management, the values were the following:  the arithmetic mean of UEWB 30g, PMRV 6ml, IPSS 7 Point and the IPSS-Quality of life 2 point. The obtained outcomes of this study were processed by descriptive statistics (standard deviation and arithmetic mean) and analytical statistics by using Student’s t-test for dependent (paired) sample. The drug side effects (Dizziness 3%and ejaculation problems3% and headache 6%) were well tolerated and acceptable and did not lead to the discontinuation   of the treatment. 

Conclusion: We conclude that UEBW is a reliable, objective test for diagnosing BOO due to BPE. Moreover, it can also be used to monitor the effect of medical therapy for BPE via its indirect effect on detrusor hypertrophy.

Key words: Benign Prostatic Enlargement, Tamsulosin, Ultrasound Bladder Wall Thickness, Ultrasound Estimated Bladder Weight.