title: Clinical significance of prostatic-urethral angulation on the treatment outcome of patients with symptomatic benign prostatic hyperplasia treated with tamsulosin hydrochloride.
abstract: OBJECTIVE
  To evaluate the impact of the prostatic-urethral angulation (PUA) on the treatment efficacy of selective alpha-1A receptor blocker in male patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH).
  
  
  METHODS
  A total of 80 patients with LUTS/BPH and with mean age 53.3 ± 6.3 (range 47-70) were included in our prospective comparative study. The patients were classified into 2 groups as a consecutive cases 40 in each one depending on the PUA either ≤ 35° (group A) or > 35° (group B). PUA and different prostatic parameters were measured using transrectal ultrasound. Prostate-specific antigen (PSA), the International Prostate Symptom Score and quality of life score (IPSS/QoL score), maximum flow rate (Qmax), and postvoid residual (PVR) volume were compared between the groups. The clinical significance of PUA was evaluated after 8 weeks of medical treatment with tamsulosin hydrochloride 0.4 mg daily.
  
  
  RESULTS
  Baseline evaluation (pre-treatment) for both groups were comparable to each other with no clinically significant difference regarding age, PSA, IPSS/QoL score, Q(max) and PVR volume (P-value > 0.05). Comparison of parameters after 8 weeks showed that tamsulosin hydrochloride improved the total IPSS and all subscores (P < 0.001), QoL (P = 0.001), Q(max) (P = 0.002), and PVR (P = 0.04) in group A (Table 1).
  
  
  CONCLUSIONS
  Tamsulosin hydrochloride appears to be less effective in improving IPSS/Qol score, Qmax and PVR in patients with lager PUA. The PUA might be a predictor for the treatment efficacy of α-blockers and more studies are warranted in the future before the final conclusion.
authors.affiliation: Urology Department, Tanta University Hospital. hassantat@yahoo.com.
authors.forename: Hassan
authors.initials: H
authors.lastname: El-Tatawy
authors.forename: Tarek
authors.initials: T
authors.lastname: Gameel
authors.forename: Mohammed Abo
authors.initials: MA
authors.lastname: El-enen
authors.forename: Ayman
authors.initials: A
authors.lastname: Hagras
authors.forename: Ayman
authors.initials: A
authors.lastname: Mousa
authors.forename: Abdel Hamid
authors.initials: AH
authors.lastname: El-Bahnasy
authors.forename: Ali Abdel
authors.initials: AA
authors.lastname: Raheem
authors.forename: Khaled
authors.initials: K
authors.lastname: Abu-dewan
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D053448:Prostatism / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D011788:Quality of Life; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D014408:Biomarkers, Tumor; D013449:Sulfonamides; D017430:Prostate-Specific Antigen; D000077409:Tamsulosin