Soliman Mohamed G, Al-Ghadeer Mohammed R, Al-Shabaan Hasan R, Al-Hamrani Amer H, AlGhadeer Hussain Adil
Department of Urology, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
Department of Family Medicine, AlAhsa Health Cluster, Al-Ahsa, Saudi Arabia.
Urol Ann. 2023 Jan-Mar;15(1):43-47. doi: 10.4103/ua.ua_143_21. Epub 2022 Nov 8.
The purpose of this study is to evaluate and assess the effect of intermittent tamsulosin treatment as a trial to increase the drug safety (in terms of reducing the drug side effects, particularly retrograde ejaculation) while maintaining the effect in reducing the symptoms and assess its impact on the patients' quality of life.
Patients who enrolled in this study were suffering from lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and were using 0.4 mg tamsulosin daily to relieve their symptoms but complained of ejaculatory problems. A baseline assessment involves medical history and evaluation of ejaculatory function abdominopelvic ultrasound, postvoid residual volume (PVR) estimation, the International Prostate Symptom Score (IPSS), quality of life assessed using global satisfaction, vital signs, physical examination including digital rectal examination, and renal function. During the study, patients consented to take 0.4 mg tamsulosin intermittently every other day and to proceed with their sexual activities on the days they did not take the drug in. Baseline assessment was repeated and recorded after 3 months from starting the treatment. The adverse effects and compliance were analyzed in all patients.
Twenty-five patients had a mean baseline IPSS of 6.6 ± 1 and baseline PVR of 87.6 ± 15.1 ml. At the 3 month, the mean PVR was 100.4 ± 15.1 ml and the mean IPSS was 7.3 ± 1.1. Moreover, 20 out of the total number of 25 patients (80%) reported improvement in their ejaculation. All our 20 patients who showed improvement in their ejaculatory function are either satisfied or very satisfied (4 or 5), in regard to the global satisfaction rate.
Intermittent tamsulosin therapy (0.4 mg/every other day) is well-tolerated and shows a potential advantage in recovery in patients who suffer from LUTS/BPH and complaining from abnormal ejaculation, especially absent ejaculate. Although there was a significant change in PVR and IPSS after using intermittent tamsulosin therapy. Most patients show a higher overall satisfaction with the treatment compared to the standard dose (0.4 mg/daily). A study on a larger scale is still needed to confirm our results.
本研究的目的是评估间歇性使用坦索罗辛治疗的效果，作为一项旨在提高药物安全性（从减少药物副作用，特别是逆行射精方面）同时维持减轻症状效果并评估其对患者生活质量影响的试验。
纳入本研究的患者因良性前列腺增生（BPH）患有下尿路症状（LUTS），且每天使用0.4mg坦索罗辛缓解症状，但抱怨存在射精问题。基线评估包括病史、射精功能评估、腹部盆腔超声、排尿后残余尿量（PVR）估计、国际前列腺症状评分（IPSS）、使用总体满意度评估的生活质量、生命体征、包括直肠指检在内的体格检查以及肾功能。在研究期间，患者同意每隔一天间歇性服用0.4mg坦索罗辛，并在未服药的日子进行性活动。从开始治疗3个月后重复并记录基线评估。对所有患者分析不良反应和依从性。
25例患者的平均基线IPSS为6.6±1，基线PVR为87.6±15.1ml。在3个月时，平均PVR为100.4±15.1ml，平均IPSS为7.3±1.1。此外，25例患者中的20例（80%）报告射精情况有所改善。就总体满意度而言，所有20例射精功能有所改善的患者均表示满意或非常满意（4或5分）。
间歇性坦索罗辛治疗（0.4mg/每隔一天）耐受性良好，对于患有LUTS/BPH且抱怨射精异常（尤其是无射精）的患者，在恢复方面显示出潜在优势。尽管使用间歇性坦索罗辛治疗后PVR和IPSS有显著变化。与标准剂量（0.4mg/每日）相比，大多数患者对该治疗的总体满意度更高。仍需要更大规模的研究来证实我们的结果。
