Objectives: In 2010, tamsulosin 0.2 mg (OD) was withdrawn from Thailand and replaced with tamsulosin 0.4 mg (OD). Therefore, we assessed the impact of this change on the patients, at a men’s health clinic, with lower...Objectives: In 2010, tamsulosin 0.2 mg (OD) was withdrawn from Thailand and replaced with tamsulosin 0.4 mg (OD). Therefore, we assessed the impact of this change on the patients, at a men’s health clinic, with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Material and Methods: Subjects were 100 men with BPH who had been taking tamsulosin 0.2 mg as needed for at least 3 months. The outcome measures were IPSS, AMS and IEFF5 scores and uroflowmetry. Tolerability was evaluated on by adverse events. Changes from baseline were assessed using the paired t-test. SPSS version 12.0 was used for statistical analysis, with p 0.05 considered significant. Results: The mean follow up of tamsulosin 0.2 and 0.4 mg were 20.23 and 10.56 months respectively. On switching from tamsulosin 0.2 to 0.4 mg, mean IPSS score improved from 15.54 ± SD 1.25 to 14.13 ± SD 1.09 (p = 0.034), Q max 15.91 cm3/sec ± SD 1.36 to 16.69 cm3/sec ± SD 1.52 (p = 0.128), and nocturia 3.15 ± SD 0.32 to 2.68 ± SD 0.39 (p = 0.015), respectively. However IEFF-5 score and AMS score increased from14.78 ± SD 1.38 to 15.79 ± SD 1.03 (p = 0.0055) and 34.76 ± SD 2.76 to 33.21 ± SD 2.62 (p = 0.0853), respectively. Treatment-related adverse events of Tamsulosin 0.2 mg included dizziness (4%), postural hypotension (3%) and retrograde ejaculation (3%). Interestingly, no withdrawals resulted from adverse events during Tamsulosin 0.4 mg assessment. Conclusions: Switching to tamsulosin 0.4 mg improves LUTS. The change was well tolerated by the majority of patients. Increased symptoms scores of erectile dysfunction and aging male during the study may be due to increased age.展开更多
After the age of 50, the prostate begins to increase in size. This is known as benign prostatic hypertrophy (BPH). Compression of urethra by enlarged prostate causes dribbling reduced force of the urinary stream, pain...After the age of 50, the prostate begins to increase in size. This is known as benign prostatic hypertrophy (BPH). Compression of urethra by enlarged prostate causes dribbling reduced force of the urinary stream, pain and occasional bleeding or infection. This causes difficulty in urinating and requires many men to get up several times during the night to urinate. The aim of our study was to evaluate an influence of new fermented whey based product (FWP) to several biochemical parameters and lower urinary tract symptoms (LUTS). Patients from the outpatient department of Andrology Center were randomized. This study involved the patients with minor to moderate LUTS, International Prostate Symptoms Score (IPSS) range 3 - 19 but not prostatitis (NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) 4 and 2-glass test negative for prostate inflammation and infection). Consumption of the FWP decreased the IPSS score in patients with moderate LUTS/BPH (p 0.001) whereas irritative and obstructive symptoms changed in parallel. There was a correlation between LUTS symptoms change and level of inflammation- and oxidative stress-related indices (blood high-sensitive C-reactive protein, hsCRP;glycated haemoglobin, HbA1c;oxidized low density lipoprotein, oxLDL;interleukine-10, IL-10 and 8-isoprostanes in the urine). Statistically significant changes in mentioned parameters occurred only in study group. Compression of urethra by enlarged prostate explains LUTS in BPH patients. Elevated oxidative stress (OxS) intensifies peroxidation of cell membrane phospholipids. This generates 8-isoprostanes (8-EPI), the prostaglandin-like compounds that can exaggerate LUTS. 8-isoprostanes may cause constriction of bladder and urethra in nanomolar concentrations. Consuming the whey-based product fermented by special lactobacilli strains may improve LUTS as well as OxS and diminish LUTS-related inflammatory response.展开更多
文摘Objectives: In 2010, tamsulosin 0.2 mg (OD) was withdrawn from Thailand and replaced with tamsulosin 0.4 mg (OD). Therefore, we assessed the impact of this change on the patients, at a men’s health clinic, with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Material and Methods: Subjects were 100 men with BPH who had been taking tamsulosin 0.2 mg as needed for at least 3 months. The outcome measures were IPSS, AMS and IEFF5 scores and uroflowmetry. Tolerability was evaluated on by adverse events. Changes from baseline were assessed using the paired t-test. SPSS version 12.0 was used for statistical analysis, with p 0.05 considered significant. Results: The mean follow up of tamsulosin 0.2 and 0.4 mg were 20.23 and 10.56 months respectively. On switching from tamsulosin 0.2 to 0.4 mg, mean IPSS score improved from 15.54 ± SD 1.25 to 14.13 ± SD 1.09 (p = 0.034), Q max 15.91 cm3/sec ± SD 1.36 to 16.69 cm3/sec ± SD 1.52 (p = 0.128), and nocturia 3.15 ± SD 0.32 to 2.68 ± SD 0.39 (p = 0.015), respectively. However IEFF-5 score and AMS score increased from14.78 ± SD 1.38 to 15.79 ± SD 1.03 (p = 0.0055) and 34.76 ± SD 2.76 to 33.21 ± SD 2.62 (p = 0.0853), respectively. Treatment-related adverse events of Tamsulosin 0.2 mg included dizziness (4%), postural hypotension (3%) and retrograde ejaculation (3%). Interestingly, no withdrawals resulted from adverse events during Tamsulosin 0.4 mg assessment. Conclusions: Switching to tamsulosin 0.4 mg improves LUTS. The change was well tolerated by the majority of patients. Increased symptoms scores of erectile dysfunction and aging male during the study may be due to increased age.
文摘After the age of 50, the prostate begins to increase in size. This is known as benign prostatic hypertrophy (BPH). Compression of urethra by enlarged prostate causes dribbling reduced force of the urinary stream, pain and occasional bleeding or infection. This causes difficulty in urinating and requires many men to get up several times during the night to urinate. The aim of our study was to evaluate an influence of new fermented whey based product (FWP) to several biochemical parameters and lower urinary tract symptoms (LUTS). Patients from the outpatient department of Andrology Center were randomized. This study involved the patients with minor to moderate LUTS, International Prostate Symptoms Score (IPSS) range 3 - 19 but not prostatitis (NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) 4 and 2-glass test negative for prostate inflammation and infection). Consumption of the FWP decreased the IPSS score in patients with moderate LUTS/BPH (p 0.001) whereas irritative and obstructive symptoms changed in parallel. There was a correlation between LUTS symptoms change and level of inflammation- and oxidative stress-related indices (blood high-sensitive C-reactive protein, hsCRP;glycated haemoglobin, HbA1c;oxidized low density lipoprotein, oxLDL;interleukine-10, IL-10 and 8-isoprostanes in the urine). Statistically significant changes in mentioned parameters occurred only in study group. Compression of urethra by enlarged prostate explains LUTS in BPH patients. Elevated oxidative stress (OxS) intensifies peroxidation of cell membrane phospholipids. This generates 8-isoprostanes (8-EPI), the prostaglandin-like compounds that can exaggerate LUTS. 8-isoprostanes may cause constriction of bladder and urethra in nanomolar concentrations. Consuming the whey-based product fermented by special lactobacilli strains may improve LUTS as well as OxS and diminish LUTS-related inflammatory response.
