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Background: The prevalence of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) in men increases with age. Alpha-adrenergic receptor antagonists are first-line drugs for the treatment of LUTS, and tamsulosin is the drug of choice. The aim of this study was to compare the efficacy of tamsulosin 0.4 mg and 0.8 mg on lower urinary tract symptoms in patients with benign prostatic hyperplasia. Methods: This double-blind clinical trial was conducted in the Urology unit of Emam Hassan Hospital in Bojnurd from May 2019 to Feb 2020. In this study, 92 patients with LUTS due to BPH were selected according to available method and randomly assigned into two groups of intervention. In the first group, patients received tamsulosin 0.4 mg and in the second group, tamsulosin 0.8 mg once daily for 8 weeks. The effectiveness of treatment was evaluated using IPSS criteria before and 8 weeks after treatment. According to a checklist, side effects were evaluated during treatment. Data was analyzed based on independent t-tests and repeated measures ANOVA by SPSS software version 22. A significance level of 0.05 was considered. Results: The results showed that the two groups were not significantly different in age and duration of symptoms. According to the statistics test, there is a significant difference between the two groups in the post-treatment phase. Also, based on analysis of variance with repeated measures statistical test, there was a significant difference between and within two groups in IPSS criteria at different stages of evaluation. The prevalence of complications was (8.6%) in the first group and (11.9%) in the second group. The prevalence of complications was not significant between the two groups. Conclusion: Tamsulosin is effective in reducing lower urinary tract symptoms and Tamsulosin 0.8 mg is an effective treatment regimen for the treatment of LUTS secondary to benign prostatic hyperplasia in those who have not responded to 0.4 mg treatment. Drug side effects were well tolerated in patients. [ABSTRACT FROM AUTHOR]

Purpose: to investigate the effect of melatonin along with tamsulosin in improving BPH urinary symptoms.Materials and Methods: A total of 108 men with BPH symptoms, age of ≥ 50 years, and International Prostate Symptom Score (IPSS) ≥ 8 entered into the parallel group randomized, double-blind clinical trial with balanced randomization. The treatment group received of 3mg melatonin plus 0.4mg tamsulosin and the control group received placebo plus 0.4mg tamsulosin. Patients and physicians were concealed by sealed and opaque envelopes. Symptoms were assessed at baseline and 1 month after treatment. Finally all scores at the initial and end of the study were compared and analyzed using SPSS software.Results: This study showed that adding melatonin to the classic treatment of BPH patients with tamsulosin could significantly reduce the likelihood of nocturia by 2.39 times (95% CI: 1.07-5.32, OR = 2.39, p = 0.033) and could also reduce the frequency of urination by 2.59 times (95% CI: 1.15-5.84, OR = 2.59, p = 0.021). There was no statistically significant difference between the two groups in IPSS, intermittency, incomplete emptying, straining, urgency, and weak stream.Conclusion: Melatonin plus tamsulosin treatment is associated with a significant improvement of nocturia and frequency in patients with benign proststic hyperplasia. However, it is necessary to do more studies. [ABSTRACT FROM AUTHOR]

Adjuvant medical expulsive therapy (MET) for shock wave lithotripsy (SWL) is controversial. With limited use of the computed tomography (CT), the stone free rate (SFR) become overestimated. Herein we evaluate tamsulosin post-SWL for renal stone using the CT to assess SFR. A randomized controlled trial (NCT05032287) was carried out for renal stone patients amenable for SWL. Patients were allocated after 1st session of SWL to receive tamsulosin 0.4 mg or placebo once daily from the 1st day of SWL and for 3-months or becoming stone free. The primary outcome was SFR, defined by presence of residual fragments (RF) ≤ 3 mm (3C-SFR). The 3C-SFR were 73.8% and 59.6% in tamsulosin and placebo groups, respectively (p = 0.03). The median (IQR) pain scores were 3 (3, 5) and 5 (3, 6) in tamsulosin and placebo groups, respectively (p = 0.04), However, the post-SWL complication and add-on analgesia needed showed no significance differences between groups. The median time for stone free were 30 days (95% CI: 27.29–32.71) in tamsulosin arm, and 36 days (95% CI: 31.01–40.99) in placebo arm, HR = 1.42 (95% CI: 1.02–1.98). Tamsulosin has more reversible adverse effect, compared to placebo (p = 0.03). In our study, the use of tamsulosin as MET following SWL facilitates expulsion of retained residual fragments. Tamsulosin shortens time to reach stone free, decreases pain scores. However, tamsulosin does not affect the add-on IV analgesics and have more reversible adverse effect, compared to placebo. [ABSTRACT FROM AUTHOR]

Introduction: Stones are common cause of obstructive uropathy which may lead to decrease in renal function. Though endourological procedure like Ureteroscopic Lithotripsy (URSL) is commonly done yet Medical Expulsive Therapy (MET) is often offered as a first line therapy for mid and distal ureteric stones of size less than one cm. Aim: To compare the effect of Tamsulosin and URSL on renal function and stone free rate for solitary mid and distal ureteric stone. Materials and Methods: This prospective interventional study was done in IPGME&R and SSKM Hospital, Kolkata, West Bengal, India, from May 2020 to October 2020, on the total study population of 50 patients with 26 patients in MET and 24 patients in URSL group. Parameters measured and compared were changes in Glomerular Filtration Rate (GFR) and stone free rate after six weeks of intervention. Numerical variables and categorical variables were compared between two groups using independent t-test and chi square test respectively. Results: The mean age of patients in MET (n=26) and URSL group (n=24) was 37.12 years and 33.63 years respectively. GFR was significantly increased after completion of treatment in individual groups (p-value=0.01) and in final study population but change in GFR was not significant when compared between the groups (p-value=0.372). Difference in stone clearance rate between two groups was also insignificant (p-value=0.902) whereas within the groups was significant (p-value<0.05). Conclusion: Tamsulosin for six weeks does not result in significant functional loss in the affected kidney and proved as effective as URSL for mid and distal solitary ureteric stone upto one cm in size with similar stone free rate. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is one of the most common malignancies in men worldwide, and prostate-specific antigen (PSA) screening is widely used for its early detection. Drug use may affect PSA levels, but the effect for most drugs is currently unknown., Methods: This study first investigated drugs related to PSA changes through the Food and Drug Administration Adverse Event Reporting System (FAERs) database, and then used a Mendelian randomization (MR) method to explore the causal relationship between specific drugs and PSA changes using a genome-wide association study (GWAS) data. The statistical analysis software SAS and R were used in the study., Results: Through analysis of the FAERs database, 22 drugs were found to be associated with an increase in PSA, and 14 drugs were associated with a decrease in PSA. MR analysis showed that the use of tamsulosin may lead to an increase in PSA. Heterogeneity test, horizontal pleiotropy test and leave-one-out Analysis verified the stability of the results. MR analyses for other drugs did not show statistical significance., Conclusion: This study provided a basis for better understanding the impact of medications on prostate health, helping to avoid overdiagnosis or underdiagnosis of high-risk patients. However, research still requires larger-scale validation and in-depth exploration.

Abstract Background Benign prostatic hyperplasia (BPH) is very common in aging men. We aimed to compare the effects of tamsulosin and pumpkin (Cucurbita pepo) seed oil on BPH symptoms. Methods This single-blind randomized clinical trial included patients with BPH aged ≥ 50 years referred to the Urology Clinic of Shahid Beheshti Hospital, Hamadan, Iran, from August 23, 2019 to February 19, 2020. Patients were randomized into two groups. One group received 0.4 mg tamsulosin every night at bedtime and the other received 360 mg pumpkin seed oil twice a day. Patients’ age, weight, height, and body mass index (BMI) were recorded. The International Prostate Symptom Score (IPSS) was filled out by the patients at baseline and then 1 month and 3 months after the initiation of treatment. The BPH-associated quality of life (QoL), serum prostate-specific antigen, prostate and postvoid residual volume, and maximum urine flow were also assessed at baseline and 3 months later. Drug side effects were also noted. Results Of the 73 patients included in this study with a mean age of 63.59 ± 7.04 years, 34 were in the tamsulosin group and 39 in the pupkin seed oil group. Patients were comparable with respect to age, weight, height, BMI, and baseline principal variables in both groups. Also, there was no significant difference between groups in terms of principal variables at any time point. However, there was a significant decrease in IPSS and a significant improvement in QoL in both groups. Although the decrease in IPSS from baseline to 1 month and 3 months was significantly higher in the tamsulosin group compared to the pumpkin group (P = 0.048 and P = 0.020, respectively), the decrease in IPSS from 1 to 3 months was similar (P = 0.728). None of the patients in the pumpkin group experienced drug side effects, while dizziness (5.9%), headache (2.9%), retrograde ejaculation (2.9%), and erythema with pruritus occurred in the tamsulosin group. Conclusions Pumpkin (Cucurbita pepo) seed oil relieved BPH symptoms with no side effects, but was not as effective as tamsulosin. Further studies are required to confirm the role of pumpkin seed oil as an option for the treatment of BPH symptoms. Trial registration Iranian Registry of Clinical Trials, IRCT20120215009014N340. Registered 19.02.2020. Retrospectively registered, https://en.irct.ir/trial/45335 .

Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter.

This study reflects that there are good results were found by the use of (Epilobium parviflorum and Nettle Urtica Dioica and Saw Palmetto (Seronoa repens) - the same as Tamsulosin and Prazosin in treatments of patients with B.PH., in which 145 patients (33.94%) were treated and improved from the (Epilobium parviflorum and Nettle Urtica Dioica and Saw Palmetto (Seronoa repens)-which is Herbal drugs, in the reduction of the size of the prostate in patients with B.P.H. This study reflects the same effect of Tamsulosin 140(32.75%) and Prazosin 142(33.25%) in relieving the prostate size. In the study we found that there is the same effects of this Herbal agent 65 (15.22%) - developed hypotension- and 120 patients (28.10%) complained from sexual dysfunctions as in Tamsulosin 105(24.60%) developed hypotension, and 105(24.60%) complained from sexual dysfunctions, and as Proposing 105(24.60%) exposed to hypotension and 105(24.60%) complained from sexual dysfunctions. [ABSTRACT FROM AUTHOR]

The objective of this subset analysis was to evaluate and compare the efficacy and tolerability of two combination treatments for men with moderate-to-severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). Data were from a real-world, open-label, prospective, and multicenter study performed in outpatient urology clinics. Men with moderate-to-severe LUTS/BPH received 6-month treatment with tamsulosin (TAM) in combination with either the hexanic extract of S. repens (HESr) or a 5-alpha-reductase inhibitor (5ARI). Changes in urinary symptoms and quality of life were measured using the IPSS and BII questionnaires, respectively. Treatment tolerability was assessed by recording adverse effects (AEs). Patients in the two study groups were matched using iterative and propensity score matching approaches. After iterative matching, data were available from 136 patients (n = 68 treated with TAM + 5ARI, n = 68 with TAM + HESr). After 6 months of treatment, mean (SD) IPSS total score improved by 7.7 (6.3) and 6.7 (5.0) points in the TAM + 5ARI and TAM + HESr groups, respectively (p = 0.272); mean BII total scores improved by 3.1 (2.9) and 2.9 (2.4) points (p = 0.751), respectively. AEs were reported by 26.5% and 10.3% of patients in the same groups, mostly affecting sexual function (p < 0.027). When used in a real-world setting to treat patients with moderate-severe LUTS/BPH, 6-month treatment with TAM + HESr was as effective as TAM + 5ARI, but with better tolerability. [ABSTRACT FROM AUTHOR]

Introduction: Benign prostatic hyperplasia (BPH) is one of the common causes of lower urinary tract symptoms (LUTS) in aging men. Men with LUTS have a higher incidence of erectile dysfunction (ED), and LUTS themselves represent an independent risk factor for ED, triggering a significant negative impact on quality of life. Materials and Methods: A total of 92 patients were randomly assigned to two groups. Groups I and II had 45 and 47 patients, two patients from Group I and three patients from Group II did not follow and were excluded from the study. Patients in Group I received 0.4 mg of tamsulosin and Group II patients received 5 mg tadalafil. Patients were assessed at baseline, 3 months, and at 6 months after receiving treatment. Treatment efficacy was measured by a change in Qmax, post void residual urine (PVR), International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM) score at 3 months and 6 months. Results: Baseline parameters between the two groups were similar. Mean Qmax improved by 7 ml/s at 3 months to 9.44 ml/s at 6 months in Group I versus 4.73 ml/s at 3 months to 6.46 ml/s at 6 months in Group II (P = 0.739). Mean PVRU decreased by 35.53 ml at 3 months to 47.23 ml at 6 months in Group I versus 44.98 at 3 months to 58.28 ml at 6 months in Group II (P = 0.102). IPSS score improved by 4.24 points at 3 months to 7.22 points at 6 months in Group I versus 4 points at 3 months to 5.02 points at 6 months in Group II (P = 0.336). SHIM score improved by 0.7 points 16.2 at 3 months to 0.8 points at 6 months in Group I versus 6.12 points at 3 months to 6.3 points at 6 months (P < 0.001). Conclusion: When both groups were compared, tadalafil showed statistically similar improvements in Qmax, PVRU, and IPSS score, but statistically significant improvement was observed with tadalafil in SHIM score compared with tamsulosin in treating LUTS secondary to BPH. Our study provides evidence that once daily tadalafil 5 mg is well tolerated and can be considered for the treatment of LUTS secondary to BPH especially in patient with ED. [ABSTRACT FROM AUTHOR]

Sensitive and green spectrofluorimetric methods were utilized for Tamsulosin Hydrochloride (TAM) and Tadalafil (TDL) assessment in bulk and their newly available combined mixture for benign prostatic hyperplasia and erectile dysfunction. The technique relies on measuring native fluorescence of TAM in 0.1 N HCl at 324 nm and TDL in 0.1 N NaOH at 348 nm due to their different fluorimetric behavior in acidic and basic media where TAM has no fluorescence in basic medium and vice versa. To achieve better regression, the spectra were derivatized allowing determination of TAM at 314 nm and TDL at 320 and 380 nm (peak to peak) by applying third and first derivative, respectively. In addition, pH-dependent "constant-wavelength synchronous" spectrofluorimetry was applied where TAM and TDL were determined at 218 nm in acidic medium and at 268 nm in basic medium, respectively. Finally, derivatizing the latter emission spectra allowed determination of TAM and TDL at 232 nm and at 262 and 278 nm (peak to peak), respectively. Acidic and basic emission spectra where scanned at λexc = 225 nm (for TAM assay) and at λexc = 247 nm (for TDL assay), respectively. Fluorescence–concentration plots were linear and the proposed methods were used for analysis of TAM and TDL combined laboratory prepared formulation. These procedures are green, sensitive and of low cost which make them suitable for quality control analysis of the two drugs. In addition, the high selectivity of the proposed methods was tested by successfully applying them for TAM and TDL assay in plasma samples. [ABSTRACT FROM AUTHOR]

To discuss the clinical effect of Qianlietongyu capsule combined with tamsulosin hydrochloride in the treatment of prostatitis complicated with premature ejaculation and its impact on the sexual life of patients. We selected 70 patients with prostatitis complicated with premature ejaculation untreated in our hospital from July 2020 to July 2021 and divided them into control group (35 cases) and observation group (35 cases). Treated control group with compound lidocaine cream, after receiving the same treatment as control group, treated observation group with tamsulosin hydrochloride and Qianlietongyu capsule. After 1 mo treatment, observation group possessed lower National Institutes of Health chronic prostatitis symptom index score than control group, but it possessed higher intravaginal ejaculation latency time than control group (p<0.05); after treatment, observation group possessed lower interleukin 8 and tumor necrosis factor alpha levels, higher maximum urinary flow rate and lower bladder residual urine volume than control group (p<0.05). After treatment, the total clinical effective rate and sexual life satisfaction of observation group were 94.29 % (33/35) and 88.57 % (31/35) respectively, those in control group were 77.1 % (27/35) and 68.57 % (24/35) respectively, the differences possessed statistical significance (p<0.05). In clinical treatment of patients with prostatitis complicated with premature ejaculation, tamsulosin hydrochloride combined with Qianlietongyu capsule can significantly improve the effect of patients’ clinical symptoms and related biochemical indicators, improve the overall clinical treatment effect and promote patients to obtain more ideal sexual life satisfaction after treatment. [ABSTRACT FROM AUTHOR]

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Objectives: To evaluate the efficacy and safety of tamsulosin and Hachimijiogan or Ryutanshakanto in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. Methods: A prospective, randomized, double‐blind method was used to determine the efficacy and safety of the combination or placebo at baseline and 4, 8, and 12 weeks of study. The International Prostate Symptom Score, quality of life index, complete voiding diary, and National Institutes of Health‐Chronic Prostatitis Symptom Index were studied. Uroflowmetery and postvoid residual urine volume were measured and compared. Laboratory tests including prostate‐specific antigen were performed. Results: In all groups, International Prostate Symptom Score and quality of life showed improvement, but no significant differences were shown among the groups. Prostate volume increased after treatment, and uroflowmetric parameters showed improvements after treatment without significance among the three groups. The total score of the National Institutes of Health‐Chronic Prostatitis Symptom Index showed a significant improvement in all groups, without significant differences among the groups. Only the pain sub‐score of the National Institutes of Health‐Chronic Prostatitis Symptom Index showed a significant decrease in the tamsulosin with Ryutanshakanto group compared to the control group. A total of 11 adverse reactions occurred, but they were mild and not related to the study drugs. Conclusion: Ryutanshakanto can provide pain relief in patients with chronic prostatitis and chronic pelvic pain syndrome. If more research is conducted, Hachimijiogan and Ryutanshakanto may be applied as add‐on treatments in patients with storage symptoms with alpha‐blocker monotherapy. [ABSTRACT FROM AUTHOR]

This study was aimed to development and modification the method of analysis for active ingredient in Tamsulosin drug by using high performance liquid chromatography (HPLC) also determined shelf life and storage conditions for Tamsulosin. Chromatographic conditions utilized stationary phase C18 (250*4.6) mobile phase 0.05Nmixture of di hydrogen ortho phosphate and Acetonitrile 55:45, preserve the flow rate near (1ml/min) and length of wave has been 275nm, The retention time found to be 10 minute for the HPLC process . The Tamsulosin assay result was found to be 99.93% . The calibration curve linearity analysis results showed a strong linear relationship in the concentration range (10-200ppm) and the correlation coefficient, slope and intercept value were 0.9933,11796,190017, respectively The percentage recovery was found 99%. LOD value was found to 0.00053 µg/ml and LOQ value was found to 0.0016 µg/ml, Precision was found to be 99.49% Robustness was found to 99.69%. Our proposed procedure confirmed a group of merits such as Linear,accurate,precise,and robust, could be recommended for determination of Tamsulosin. [ABSTRACT FROM AUTHOR]

Objective: We designed this study to investigate the potential use of N‐acetylcysteine (NAC) as an adjunct to alpha‐blockers in the treatment of category III chronic prostatitis (CP). Methods: Sixty‐three men with category III CP with a National Institutes of Health Chronic Prostatitis Symptom Index (NIH‐CPSI) total score of 15 or more were randomized to either the NAC treatment group or the placebo treatment group. Besides tamsulosin at a dose of 0.4 mg once daily, participants based on their allocation group received NAC or placebo at a dose of 600 mg twice daily for 12 weeks. The efficacy of the medications was assessed by measuring changes in the NIH‐CPSI total score and its subscales, including pain, urinary symptoms, and quality of life. Results: Based on the general linear model analysis of the data, over the 12‐week treatment, NAC+tamsulosin was statistically superior to placebo+tamsulosin in reducing the total NIH‐CPSI score, pain subscore, and quality‐of‐life subscore (P value <.001). Further, after 12 weeks, more patients in the NAC+tamsulosin group than in the placebo+tamsulosin group met the responder criterion, defined as a decrease of at least 6 points in the NIH‐CPSI total score (65.6% vs 29.0%). A more favorable outcome was also noted in the NAC+tamsulosin group regarding the number of patients reporting moderate or marked improvement in symptoms (62.5% vs 25.80%). No significant difference was seen between the groups concerning changes in urinary symptoms. Conclusions: Our study provided clinical evidence that men with category III CP might benefit from NAC treatment. Further studies are needed for the validation of these findings. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose: To compare the effects of tadalafil, tamsulosin, and placebo as a medical expulsive therapy (MET) for distal ureteral calculi. Materials and Methods: This prospective randomized double-blind clinical trial was conducted on 132 renal colic patients with distal ureteric stones (≤10mm) over a period of 12 months. Patients were randomly divided into three groups. Patients in group A received tamsulosin 0.4mg, in group B received tadalafil 10mg, and in group C received placebo. Therapy was given for a maximum of 4 weeks. The rate of stone expulsion, duration of stone expulsion, the dose and the duration of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesic use, and adverse effects of drugs were recorded. Results: Demographic profiles were comparable between the 3 groups. Although the stone expulsion rate in group A (72.7%) was higher in comparison to group B(63.6%) and group C(56.8%), it was not considered statistically significant (P=0.294). Shorter mean time to stone expulsion was significantly observed in group A (17.75±75), than group B(21.13±1.17) and group C(22.25±1.18) (P=0.47). The mean number of analgesic use was 9.8±5.09 days in group A, 14.6±7.9 days in group B, and 12.6±22.25 days in group C, this difference was significant (P=0.004). The analgesic requirement (doses of NSAIDs and pethidine) in group A was significantly lower than other groups (P

ObjectiveRecent studies have clarified the role of alpha-blockers, such as tamsulosin, for patients diagnosed with ureteral stones

Platypnea-orthodeoxia syndrome (POS) is an extremely rare condition. There are no other cases in the literature where tamsulosin has been reported to prolong POS treatment. A 67-year-old male patient was hospitalized due to COVID-19. He was followed up in the ward after being in the intensive care unit for ten days. There was a significant decrease in saturation (SaO2) when sitting and standing compared to lying. He was diagnosed with POS. However, there was no significant improvement in POS with exercises. After stopping the tamsulosin he was using, there was a dramatic improvement. He was discharged on the 72nd day of his hospitalization. Due to COVID-19, POS is more likely to appear than before. It is a condition that clinicians should recognize. The pathophysiology of POS has not been fully elucidated. The case we present suggests that alpha-blockers may also be related to pathophysiology. [ABSTRACT FROM AUTHOR]

Study objectiveTamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone.MethodsMEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design. Meta-analysis was conducted with a random-effects model and subgroup analyses were conducted to determine sources of heterogeneity.ResultsEight randomized controlled trials (N=1,384) contained sufficient information for inclusion. The pooled risk of stone passage in the tamsulosin arm was 85% versus 66% in the placebo arm, but substantial heterogeneity existed across trials (I2=80.2%; P

Background: Alpha-adrenoreceptor antagonists or alpha-blockers are used in the treatment of hypertension, in the therapy of benign prostatic hyperplasia and in medical expulsive treatment of ureteral stones. These agents may affect the sexual function, with differences between drugs within the same class, depending on their selectivity for receptor subtypes. The aim of this review was to analyze the effects of alpha-blockers on sexual function. Materials and methods: We conducted a systematic review and meta-analysis by searching PubMed, EMBASE and other databases for randomized controlled trials (RCTs) reporting sexual adverse effects in patients treated with alpha-blockers. Odds ratios for sexual dysfunction were calculated using random effects Mantel-Haenszel statistics. Results: Out of 608 records retrieved, 75 eligible RCTs were included in the meta-analysis. Compared with placebo, alphablockers were associated with increased odds of ejaculatory disorders both in patients with lower urinary tract symptoms (LUTS) associated to benign prostatic hyperplasia (BPH) (OR: 7.53, 95% CI: 3.77-15.02, Z = 5.73, p < 0.00001, I2 = 55%) and in patients with ureteral stones (OR: 2.88, 95% CI: 1.50-5.44, Z = 3.19, p < 0.001, I2 = 31%). Uroselective alpha-blockers showed higher odds of ejaculatory disorders. Conversely, nonselective alpha-blockers were not associated with higher odds of ejaculatory dysfunction. Silodosin was associated with increased odds of ejaculatory dysfunction compared with tamsulosin (OR: 3.52, 95% CI: 2.18-5.68, 15 series, 1512 participants, Z = 5.15, p < 0.00001, I2 = 0%). Naftopidil and alfuzosin showed lower odds of ejaculatory dysfunction compared to uroselective alpha-blockers.No statistically significant differences in the odds of erectile dysfunction were observed when alpha-blockers were compared to placebo.

PurposeAlthough several previous studies have investigated the relationship between tamsulosin use and surgical complications of cataract surgery, no population-based cohort study has been conducted for the Asian population. We aimed to investigate the relationship between tamsulosin use and surgical complications of cataract surgery in the Korean elderly population.MethodsThis nationwide population-based retrospective cohort study included elderly patients (≥60 years) who had undergone cataract surgery in the period from 2003 to 2015. Baseline characteristics were age, sex, income, residence, and systemic, and ocular comorbidities (glaucoma, myopia, eye trauma, diabetes mellitus with ophthalmic manifestations, severe cataract, age-related macular degeneration). The exposure of interest was tamsulosin use within 1 year before cataract surgery. Logistic regression model was used to evaluate the relationship of tamsulosin use with surgical complications of cataract surgery.ResultsThe rate of surgical complications of cataract surgery was 0.88% (375/42,539) in the non-tamsulosin group and 0.83% (71/8,510) in the tamsulosin group. The groups showed no significant difference in the risk of surgical complications of cataract surgery in the unadjusted model [odds ratio (OR) = 0.946; 95% confidence interval (CI):0.733–1.220; P = 0.669]. Additionally, tamsulosin use was not significantly associated with surgical complications of cataract surgery in the fully adjusted model accounting for age, income, residence, and systemic and ocular comorbidities (OR = 0.997; 95% CI: 0.749–1.325; P = 0.981).ConclusionsThe rate or risk of surgical complications of cataract surgery does not change with tamsulosin use. We suggest that better surgical techniques and surgeons' cognizance of the patient's tamsulosin use could improve surgical outcomes, without increasing surgical complications.

Abstract Background The insertion of a double-J (DJ) stent is considered a routine and necessary urological procedure. It can cause lower urinary tract symptoms (LUTS). Pharmacologic management is one of many trials that were done to improve these symptoms, particularly the administration of alpha-1A blockers and antimuscarinics medications. This trial aimed to evaluate the efficacy of alpha-1A blocker (tamsulosin), antimuscarinic (solifenacin), and their combination in managing DJ stent-related LUTS. Methods This prospective, randomized, comparative, and nonblinded trial was conducted between November 2016 and October 2018. Eligible patients were between 18 and 50 years of both genders who underwent temporary retrograde unilateral Double-J stent fixation. Patients were randomized to four groups; group I was control (drug-free), group II received tamsulosin 0.4 mg, group III received solifenacin 5 mg, and group IV received the combination of tamsulosin and solifenacin. All patients completed the IPSS, QoL, and VAS questionnaires at both pre-insertion day of the stent and 2 weeks postoperatively; the data obtained were compared to all four groups. Results The study included 143 patients (78 males, 65 females). There was no statistically significant difference between the four groups regarding age, sex, side, and DJ placement indications. In comparison with the control group, there were statistically significant differences in all scores in favor of groups II, III, and IV. Compared to groups II and III, there were statistically significant differences in overall IPSS, QoL, and VAS scores in group IV. No significant differences were found between the tamsulosin and solifenacin groups. Conclusion The alpha-1A blocker (tamsulosin) or antimuscarinic (solifenacin) monotherapy effectively improves the DJ stent-related LUTS and the QoL of patients with no advantage with either drug. The combination therapy of both pharmacotherapies is significantly effective than drug monotherapy.

Introduction To compare the effectiveness of tamsulosin and Tolterodine in reducing stent-related symptoms with each other and with the control group we performed this randomized clinical trial. Methods 150 patients after successful first-time transurethral lithotripsy (TUL) for unilateral ureteral stones were elected for the study 17 patients were excluded in the first allocation. Other patients were randomized (With balanced blocked randomization) into three groups. In group 1, 41 patients received Tamsulosin (Omnic) 0.4mg once a day for a month and in group 2, 42 patients received tolterodine (Detrusitol) 2mg once a day for a month. In group 3, which was our control group, 50 patients received a placebo once a day for a month. Clinical stent-related symptoms questionnaires at the first visit (day 10) and before removing themes stent were completed. Two urine tests and an x-ray of the abdomen in the first visit have been performed. Results Despite the remarkable decrease in the severity of stent-related symptoms other than urine urgency in the control group (p-value0.05). Conclusion The results of our study show that administration of tolterodine and tamsulosin to reduce stent-related symptoms do not have superiority to each other and the control group.

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 underwent unilateral DJ stenting for different endourological procedures, were enrolled after satisfying inclusion/exclusion criteria 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