Efficacy of Dose Escalation of Tamsulosin for the Treatment of Lower Urinary Tract Symptoms.

Objectives: The aim of this study was to compare the efficacy of low (0.2 mg) and intermediate (0.4 mg) dose tamsulosin in treating lower urinary tract symptoms (LUTS).

Methods: Patients were treated with low-dose tamsulosin for an initial run-in period of 12 weeks, then divided into two groups based on their clinical improvement. Patients were measured for objective parameters of peak flow rate and postvoid residual urine volume, as well as subjective symptom scores and perceived patient benefit of treatment. The items were then integrated as the LUTS Outcome Score to determine dose increase or maintenance. Overall outcome was determined at 36 weeks.

Results: One hundred and seventy-four patients were enrolled and started on 0.2 mg tamsulosin treatment. One hundred and fifty-five patients completed the 36-week study. Sixty patients required dose increase to 0.4 mg at the 12th week. Baseline characteristics showed that a patient who would benefit from 0.4 mg dosage had higher age, daytime frequency, and lower peak urine flow rate. Patients receiving both 0.2 and 0.04 mg both showed improved clinical outcome measures. Higher improvement was found in voiding component symptom scores and urine flow rate improvement in patients receiving an increased dose.

Conclusion: Both low- and intermediate-dose tamsulosin are effective treatment regimens. Increasing from low to intermediate dose should follow assessment of both objective and subjective improvements.