title: Intravesical prostatic protrusion can be a predicting factor for the treatment outcome in patients with lower urinary tract symptoms due to benign prostatic obstruction treated with tamsulosin.
abstract: OBJECTIVE
  To assess the effect of the intravesical protrusion of the prostate (IPP) on the response to medical treatment with tamsulosin for a 3 month period.
  
  
  METHODS
  The study, which was conducted between 2009 and 2011 in the ambulatory clinic of an academic hospital, divided 183 patients with lower urinary tract symptoms due to benign prostatic obstruction in 2 groups (90 and 93 patients, respectively) according to intravesical prostatic protrusion (IPP): group A ≤10 mm; group B >10 mm. Patients were treated with tamsulosin (0.4 mg, once daily) for 3 months. The International Prostate Symptom Score (IPSS; -35% and -3 points) and maximum urinary flow (Qmax) assessed by uroflowmetry (+1.6 mL/s and +25%) response criteria were defined. Patients' responses from the 2 groups were compared.
  
  
  RESULTS
  After 3 months of treatment, Qmax increased, with 2.74 mL/s (25%) in group A (P <.01) and 1.59 mL/s (19%) in group B (P = .07). IPSS decreased, with 39.9% (P < .01) and 29.7% (P = .08), respectively. Statistically significant differences were noted for IPSS -35% responders (78% group A vs 58% group B, P <.01), -3 points IPSS responders (82% vs 64%), Qmax +25% responders (82% vs 58%), and Qmax +1.6 mL/s responders (85% vs 62%, P <.01). No major adverse events occurred. The relative small number of patients enrolled was the main study limitation.
  
  
  CONCLUSIONS
  Men with IPP exceeding 10 mm seem to be more frequently poor responders to medical treatment with tamsulosin among patients with lower urinary tract symptoms due to benign prostatic obstruction, prostatic volume <40 mL, and prostate-specific antigen <1.5 ng/mL.
authors: Department of Urology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. alincumpanas@hotmail.com
authors: Alin Adrian
authors: AA
authors: Cumpanas
authors: Mircea
authors: M
authors: Botoca
authors: Radu
authors: R
authors: Minciu
authors: Viorel
authors: V
authors: Bucuras
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D014463:Ultrasonography; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin