初診斷前列腺肥大台灣病人以tamsulosin 0.4mg 治療的成效
洪肇澤 楊緒棣
台北慈濟醫院泌尿科
The tolerance of tamsulosin 0.4mg (Harnalidge® OCAS®) in managing benign prostate obstruction in treatment-naive Taiwanese men
Chao-Tse Hung, Stephen Shei-Dei Yang
Division of Urology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei Taiwan. Medical College of Buddhist Tzu Chi University, Hualien, Taiwan.
Objectives: In Taiwan, the recommended initial dosage of tamsulosin for managing men’s lower urinary tract symptoms (LUTS) is 0.2mg per day. The aim of the study is to evaluate the tolerance of tamsulosin 0.4mg (Harnalidge® OCAS®) in managing LUTS related to benign prostate obstruction (BPO) in Taiwanese men.
Material and Methods: From 2015 Jan to 2015 Dec, we retrospectively reviewed men with LUTS suggestive of BPO visiting urologic clinics without previous exposure to alpha blockers or 5-alpha reductase for study. Exclusion criteria were those with urethral stricture, previous prostate surgery, chronic kidney disease under dialysis, acute urine retention under urethral catheterization and prostate or bladder cancer. Baseline patient characteristics including age, international prostatic symptom score (IPSS), total prostate volume, uroflowmetry and post-void urine volume were recorded.
Results: Finally, 194 alpha-blockers naive men (mean age=70.5±14.2 years) were enrolled for analysis with. The baseline IPPS, prostate size, Qmax, PVR was 13.9±6.3 points, 53.9±22.8 gm, 11.5±4.7 ml/sec, and 39.4±33.2 mL respectively. There were only 4 shifted to the other alpha blockers (2 silodosin and 1 tamsulosin 0.2 mg due to side effects and 1 doxazosin due to poor effect) with a mean follwup of 137±181 days. The Qmax and PVR improved to 12.8±5.5 ml/sec (p=0.08) and 36.2±46.1 ml (p=0.65) at 3 months followups while not statistically significant.
Conclusions: Tamsulosin 0.4 mg is well tolerated in alpha-blcokers naïve patients without significant side effects and therefore dose titration of Harnalidge® OCAS® is not warranted in Taiwanese men.