Chang Shang-Jen, Chiang I-Ni, Yu Hong-Jeng
Department of Urology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan.
Int J Urol. 2008 Oct;15(11):981-5. doi: 10.1111/j.1442-2042.2008.02134.x. Epub 2008 Aug 20.
To prospectively evaluate the effectiveness of tamsulosin in treating women with voiding difficulty.
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.
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.
Tamsulosin has beneficial effects in a significant proportion of women with voiding difficulty.
前瞻性评估坦索罗辛治疗有排尿困难女性的有效性。
有慢性、困扰性排尿症状且尿流率低于正常的女性患者,每天服用0.2mg坦索罗辛,持续六周。结果分析包括国际前列腺症状评分以及排尿后残余尿量的尿流率测定。排尿症状评分降低50%或更多,同时最大尿流率增加30%或更多的患者被视为有良好的治疗反应。根据压力-流率研究,对被归类为膀胱出口梗阻或逼尿肌活动低下的患者进行亚组分析,排除留置导尿或间歇性自我导尿的患者以及有解剖学梗阻的患者。
97名患者符合研究纳入标准并被纳入。所有服用坦索罗辛的患者在排尿症状评分、储尿症状评分、最大尿流率、排尿后残余尿量和排尿效率方面均有显著改善。35.1%的患者有良好的治疗反应。其中,33名被归类为膀胱出口梗阻,52名有逼尿肌活动低下。虽然两组患者的排尿症状评分均显著降低,但膀胱出口梗阻患者更有可能降低其排尿症状评分。两组之间尿流参数的改善程度以及有良好治疗反应的患者比例(膀胱出口梗阻组为39.4%,逼尿肌活动低下组为32.7%,P = 0.69)相似。不良事件轻微且可耐受。
坦索罗辛对相当一部分有排尿困难的女性有有益作用。