title: Voiding impairment after prostate biopsy: does tamsulosin treatment before biopsy decrease this morbidity?
abstract: OBJECTIVE
  To evaluate the association of transrectal ultrasound (TRUS)-guided prostate biopsy with voiding impairment and to investigate whether tamsulosin treatment given before prostate biopsy could improve voiding impairment after the procedure.
  
  
  METHODS
  The study included 66 consecutive patients who underwent TRUS-guided 12-core prostate biopsy and were prospectively randomized. Of the patients, 33 were treated with tamsulosin (0.4 mg daily) beginning the day before the biopsy procedure for 30 days. The remaining 33 patients underwent TRUS-guided prostate biopsy only with no tamsulosin treatment and served as the control group. The International Prostate Symptom Score (IPSS) and maximal flow rate (Qmax) were recorded in all patients before the procedure and on postbiopsy days 7 and 30. All patients were followed up and questioned about difficulty voiding and acute urinary retention after the procedure.
  
  
  RESULTS
  No difference was found in the mean IPSS and Qmax before biopsy between the two groups (P >0.05). Acute urinary retention after the biopsy procedure developed in 1 patient in the tamsulosin group and 3 patients in the control group. The rate of voiding difficulty on postprocedure day 7 was significantly lower in the tamsulosin group (9.09%) than in the control group (42.42%), a statistically significant difference (P <0.001). In the tamsulosin group, the IPSS was significantly decreased on postbiopsy days 7 and 30 compared with the baseline value (P <0.05 and P <0.001, respectively), and Qmax was significantly elevated on postbiopsy day 30 (P <0.01). In the control group, the IPSS was significantly greater (P <0.05) and the Qmax was significantly lower (P <0.001) on postbiopsy day 7 compared with the baseline value.
  
  
  CONCLUSIONS
  The results of our study show that TRUS-guided prostate biopsy leads to transient voiding impairment, and therefore, the alpha(1)-blocker tamsulosin before biopsy and for a brief interval afterward may decrease this morbidity.
authors.affiliation: Department of Urology, University of Mersin School of Medicine, Zeytinlibahce Caddesi, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Bozlu
authors.forename: Ercüment
authors.initials: E
authors.lastname: Ulusoy
authors.forename: Erdal
authors.initials: E
authors.lastname: Doruk
authors.forename: Selahittin
authors.initials: S
authors.lastname: Cayan
authors.forename: Bülent
authors.initials: B
authors.lastname: Canpolat
authors.forename: Paul F
authors.initials: PF
authors.lastname: Schellhammer
authors.forename: Erdem
authors.initials: E
authors.lastname: Akbay
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D016055:Urinary Retention / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology* / Q000517:prevention & control; D014563:Urodynamics
chemical_list: D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin