Abstract
TO STUDY THE OUTCOME OF ALPHA BLOCKER (TAMSULOSIN) THERAPY IN BPH PATIENTS WITH CORRELATION TO THEIR URINARY BLADDER WALL THICKNESS

Dr. Sudheer Rathi, MS MCH (Urology), Dr. Amit, MS (Surgery) SR and *Dr. Anuj Sharma

ABSTRACT

Introduction: Benign prostatic hyperplasia (BPH) is a common condition in older men. The prevalence of BPH increases with age. The most common lower urinary tract symptoms are hesitancy, weak stream, nocturia, and incontinence. BPH may also be complicated by recurrent urinary tract infections (UTIs)3 or bladder stones4. It is estimated that one half of all men with histologic BPH experience moderate to severe lower urinary tract symptoms5. The study aim is to investigate the effect of Tamsulosin on the measurement of bladder wall thickness in patients of benign prostatic hyperplasia, to investigate the effect of Tamsulosin on International Prostate Symptoms Score in patients of Benign Prostatic hyperplasia with correlation to their urinary bladder wall thickness & to study the outcome of alpha blocker (Tamsulosin) Therapy inBPH patients with correlation to their urinary bladder wall thickness. Methods & Materials: 140 patients with Benign prostatic Hyperplasia coming to Surgery OPD and getting admitted to the department of surgery between June 2014 to Sept 2015, were analyzed prospectively. The data regarding clinical data, including digital rectal examination (DRE) and IPSS of previously diagnosed BPH patients with LUTS were obtained by questionnaire- interview with the patients themselves. The data was analyzed by SPSS 21.0 version. Result: Out of 140 patients During the first 2 months, 8 patients lost follow up and 10 patients found to be poor drug compliance. Finally 122 patients with BPH, who properly complied with the regimen, were included in this study. In this study. Most of the study population presented with prostate size between 41-60 cc with mean prostate volume 47.86 ±17.27 cc, with Bladder Wall Thickness between 6.01-6.50 mm in 28 patients least being between 6.51 to 7.0 mm and 9.01 to 9.50 mm in 5 patient each with mean thickness 6.55±1.42 mm & with total IPSS and the voiding symptom subscore between 8-19/35 with mean IPSS 15.54±4.16. Aan Alphablocker Tamsulosin (0.4 mg) was prescribed to all patients for 8 weeks. After 8 weeks of medication, the IPSS was reevaluated and the patients were divided into two Groups. The Responder Group included patients who reported improvement of the IPSS storage symptom subscore of 2 points or more. The Nonresponder Group included patients who reported no or < 2 points improvement of the IPSS storage symptom subscore. In this study we found that prostate volume had no significant influence with BWT in Nonresponder Group and in Responder Group. There is no significant improvement in IPSS in patients with high bladder wall thickness. There is significant improvement in IPSS in patients with less bladder wall thickness. Conclusion: Bladder Wall Thickness was related to IPSS and the storage symptom score in LUTS/BPH patients. With Bladder Wall Thickness increase, the responsiveness of alphablockers to irritative symptom was decreased in LUTS/BPH patients. Bladder Wall Thickness may be a useful parameter for predicting responsiveness of irritative symptoms to alphablocker therapy in LUTS/BPH patients. Patient having bladder wall thickness > 7 mm can be planned for operative modality of treatment directly as majority of Non Responder Group are among them, without alfa blocker therapy and outcome of this therapy can be assessed further in other study.

Keywords: BPH, DRE, IPSS, LUTS.


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