title: The effect of combined therapy with tamsulosin hydrochloride and meloxicam in patients with benign prostatic hyperplasia symptoms and impact on nocturia and sleep quality.
abstract: OBJECTIVE
  We aimed to compare the effect and feasibility of a combined therapy with tamsulosin hydrochloride plus meloxicam, and tamsulosin hydrochloride alone in patients with benign prostate hyperplasia symptoms and impact on nocturia and sleep quality.
  
  
  METHODS
  Four hundred male patients were included in this study between 2008 and 2011. Patients were randomly divided into two groups: one received tamsulosin hydrochloride 0.4 mg (Group 1, 200 patients) and the other tamsulosin hydrochloride 0.4 mg plus meloxicam 15 mg (Group 2, 200 patients) prospectively. Patients were evaluated for benign prostate hyperplasia (BPH) symptoms according to the American Urological Association clinical guidelines and sleep quality according to Pittsburgh Sleep Quality Index (PSQI). Patients were reevaluated after three months of treatment. The International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Qmax), average urinary flow rates (AFR), post void residual urine volumes (PVR), nocturia and Pittsburgh Sleep Quality Score (PSQS) were recorded at baseline and after three months.
  
  
  RESULTS
  Mean age was 63.3 ± 6.6 and 61.4 ± 7.5 years in groups 1 and 2, respectively (p = 0.245). There were no statistically significant differences between both groups. Also, baseline prostate specific antigen (PSA), prostate volume, creatinine, International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Qmax), average urinary flow rates (AFR), post void residual urine volumes (PVR), nocturia and Pittsburgh Sleep Quality Score (PSQS) were similar in both groups. In addition, the total IPSS, IPSS-QoL, PVR, nocturia, and PSQS were significantly lower in Group 2 compared with Group 1 after treatment (p < 0.05). Qmax and AFR were higher significantly in Group 2 compared with Group 1 after treatment (p < 0.05).
  
  
  CONCLUSIONS
  Cyclooxygenase (COX)-2 inhibitors in combination with an alpha blocker may decrease benign prostatic hyperplasia symptoms and increase sleep quality without serious side effects.
authors.affiliation: Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Sacit Nuri
authors.initials: SN
authors.lastname: Gorgel
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Sefik
authors.forename: Osman
authors.initials: O
authors.lastname: Kose
authors.forename: Vural
authors.initials: V
authors.lastname: Olgunelma
authors.forename: Evren
authors.initials: E
authors.lastname: Sahin
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage; D000368:Aged; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage*; D004359:Drug Therapy, Combination / Q000379:methods; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D000077239:Meloxicam; D008875:Middle Aged; D053158:Nocturia / Q000188:drug therapy*; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D011788:Quality of Life; D012016:Reference Values; D012890:Sleep / Q000187:drug effects*; D018709:Statistics, Nonparametric; D013449:Sulfonamides / Q000008:administration & dosage*; D000077409:Tamsulosin; D013843:Thiazines / Q000008:administration & dosage*; D013844:Thiazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014554:Urination / Q000187:drug effects
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D052246:Cyclooxygenase 2 Inhibitors; D013449:Sulfonamides; D013843:Thiazines; D013844:Thiazoles; D000077409:Tamsulosin; D000077239:Meloxicam