The Characteristics of Voiding Difficulty in Women and the Effect of Tamsulosin

Purpose: The aim of this study was to define the characteristics of female voiding difficulty, and evaluate the effects of the alpha-blocker, tam- sulosin, on the symptoms in those patients. Materials and Methods: 148 patients, who complained of voiding difficulty between March 2002 and September 2004, were retrospectively evaluated. 32 patients with anatomical and neuropathic causes were excluded, with the remaining 116 assigned to 4 groups from their urodynamic evaluations: group I, bladder outlet obstruction (BOO) only; group II, BOO plus an overactive bladder (OAB); group III, detrusor underactivity (DU) only; and group IV, DU plus an OAB. After 2 weeks of observation, tamsulosin, 0.2mg/d, was prescribed in all groups, with the patients re-evaluated after 3 months. Results: 58 (50%), 23 (19.8%), 20 (17.3%) and 15 (12.9%) of the 116 study subjects were placed into groups I, II, III and IV, respectively. In group I, 45 (77.5%) had symptomatic improvement after taking tamsulosin for 3 months, and in group II improvement was observed in 73.9% (17/23) of patients. In groups III and IV; however, improvements were seen in only 25 (5/20) and 13.3% (2/15) of cases, respectively. Dizziness, postural hypotension and urinary incontinence occurred in some patients, but these disappeared after the medication was discontinued. Conclusions: 81 patients (69.8%) had a bladder outlet obstruction, without detrusor underactivity, and 62 (76.5%) of these exhibited a voiding im- provement after taking tamsulosin for three months. However, in patients with detrusor underactivity, the response rate was very low (20%).