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Purpose Assess the efficacy of selective alpha-1 blocker (tamsulosin) and antimuscarinic (solifenacin) as well as their combination in alleviating lower urinary tract symptoms in patients with ureteric stents using the brief-form Chinese version of the USSQ. Methods A prospective randomized control study was conducted from May 2023 to October 2024 in the Urology department at Aswan University Hospital involving 160 consecutive patients undergoing DJ insertion after uncomplicated ureteroscopy. All patients are randomized into 4 groups receiving different treatments. Groups A, B, C, and D received a placebo, tamsulosin 0.4 mg, solifenacin 5 mg, and combinations respectively. IPSS and USSQ (brief-version) were collected and analyzed on the 1st day, 1st week, and 3rd week postoperative. Results In all, 158 patients completed the study, 39 patients for Group A and Group B, while 40 patients for Group C and Group D. Baseline characteristics were comparable among all groups. Group (D) showed a significant decrease in mean ± (SD) IPSS 9.5 (± 1.4), and 7.7 (± 1.3) on 1st week and 3rd week postoperative respectively. Regarding USSQ, group (D) showed significantly lower scores compared to groups (A), (B), and (C) on the 1st day, 1st week, and 3rd week postoperatively (p < 0.001, p < 0.001, p < 0.001; respectively). Conclusion The brief-form USSQ is a useful, reliable substitute for evaluating stent-related symptoms. Our findings support the notion that tamsulosin/solifenacin combinations have considerably reduced LUTS linked to the placement of ureteral stents.

Background Modeling studies using large datasets from men with lower urinary tract symptoms/benign prostate enlargement (LUTS/BPE) can predict changes in International Prostate Symptom Score (IPSS) and risk of acute urinary retention/surgery under different treatment regimens and according to predictors (baseline characteristics) that commonly define risk of progression. We assessed the impact of treatments on different symptom types (storage, voiding, and nocturia), quality of life (QoL; IPSS Q8), and BPH Impact Index [BII]). Methods Generalized least squares models were used to predict each outcome. Data from the CombAT study were used to predict outcomes for active treatments (dutasteride, tamsulosin, combination therapy). Predictors included: age; IPSS total, storage, voiding, nocturia and QoL (IPSS Q8) scores; BII; prostate volume; maximum urine flow rate (Qmax), prostate-specific antigen, postvoid residual urine (PVR); alpha-blocker usage within 12 months. Data from phase III dutasteride monotherapy studies were used to predict placebo outcomes. Results were visualized using an interactive web-based tool ( www.bphtool.com ). Results Combination therapy provided greater predicted benefit than either monotherapy for all five outcomes for most patient profiles within the CombAT inclusion criteria. PVR and corresponding subscores were significant predictors of change in both storage and voiding subscores. Alpha-blocker use within 12 months, age (storage subscore), and Qmax (voiding subscore) were also significant predictors. PVR, age, Qmax, and nocturia score were significant predictors of change in nocturia. PVR, Qmax, previous alpha-blocker use, total IPSS, and QoL (IPSS Q8) score were significant predictors of change in QoL (IPSS Q8) score. For BII, significant predictors were PVR, age, total IPSS, and BII score. The multivariable effect of covariates and treatments is best visualized through the interactive web-based tool. Conclusions This predictive modeling study informs our understanding of how risk factors for disease progression interact and affect treatment impact on different symptom types and QoL scores.

Purpose To compare the efficacy and the safety of Tamsulosin 0.4 mg/day and 0.8 mg/day in patients suffering from lower urinary tract symptoms due to benign prostatic obstruction. Patients and Methods A prospective interventional, double-blinded, controlled study was carried out on 93 patients who met the criteria and divided randomly into two groups: group A for Tamsulosin 0.4 mg/day and group B for Tamsulosin 0.8 mg/day. International prostate symptom score, post void residual urine volume, and maximum flow rate of urine were assessed before and after 4 weeks of treatment. Results Both study groups showed a significant reduction in storage sub-score but only frequency was significantly reduced in group B ( P  < 0.001). On the other hand, Tamsulosin 0.8 mg was superior to Tamsulosin 0.4 mg regarding voiding sub-score except for straining ( P  = 0.325). Accordingly, the total international prostate symptom score was significantly improved in group B versus group A ( P  < 0.001). Furthermore, maximum flow rate and post-void residual urine volume were notably improved in Group B as compared to Group A ( P  < 0.001). Of all adverse events only dizziness was noted to be statistically significant in Group B versus Group A ( P  < 0.001). Conclusion Tamsulosin 0.8 mg has shown better outcomes in treating patients who suffer from lower urinary tract symptoms due to benign prostatic enlargement than Tamsulosin 0.4 mg, and besides that, it is well tolerated. Trial registration number M S 292/2020, SID: 373, date: 22/4/2020.

To explore whether sexual intercourse is beneficial to the clinical outcome of SWL for ureteral calculi of 7-15 mm in the distal ureter. Between March 2016 and January 2017, 225 patents with a stone (7-15 mm) in distal ureter were randomly divided into three groups after SWL: Group 1 was asked to have sexual intercourse at least three times a week, Group 2 was administered tamsulosin 0.4 mg/d and Group 3 was received standard therapy alone and served as the controls. Stone free rate, time to stone expulsion, pain score at admission, number of hospital visits for pain and steinstrasse were recorded in 2 weeks. 70 patients in Group 1, 71 patients in Group 2 and 68 patients in Group 3 were enrolled to the study. At the end of the first week and the second week, the stone free rates for Group 1 (68.6%, 80.0%) and Group 2 (69.0%, 81.7%) were approximately the same, but were significantly higher than Group 3 (50.0%, 63.2%) (P = .031, P = .022). The VAS scores of Groups 1 and 2 were slightly higher than those of Group 3 (P = .233). The number of patients in Group 3 who visited the emergency room for pain was significantly higher than in the other two groups (P = .015). At the end of the second week, the incidence of steinstrasse in Groups 1 and 2 was significantly lower (2.9%, 2.8% vs 11.8%) (P = .034). At least three sexual intercourses per week after SWL can effectively improve the stone free rate, reduce the formation of steinstrasse and relieve renal colic. It provides a choice for urologists in the SWL treatment of lower ureteral calculi.

This study aimed to evaluate the efficacy and safety of combining external physical vibration lithecbole (EPVL) with tamsulosin to enhance the clearance of upper ureteric stones (10–20 mm) after extracorporeal shock wave lithotripsy (ESWL). In a prospective, randomized clinical trial, patients with upper ureteric stones were allocated to a control group receiving ESWL followed by daily tamsulosin (0.4 mg) or a treatment group receiving both ESWL and EPVL in addition to tamsulosin. The primary endpoint, the stone-free rate (SFR), was assessed at 1, 2, and 4 weeks post-ESWL. Secondary endpoints included complication rates, with radiologic evaluations conducted at predetermined intervals to monitor stone clearance. In this randomized trial involving 211 participants, 106 received the intervention, while 105 served as controls. EPVL significantly enhanced stone fragment clearance. At week one, the SFR between the groups was similar (51.9% vs. 45.4%, P =  0.912). However, at weeks two and four, the treatment group demonstrated significantly higher SFR of 81.1% and 90.6%, respectively, compared to 64.8% and 75.2% in the control group ( P =  0.020 and P =  0.011). No significant differences were observed in complication rates ( P >  0.05). The treatment group underwent an average of 6.2 EPVL sessions, with a mean stone expulsion time of 20.3 ± 4.7 days. The combination of EPVL and tamsulosin following ESWL significantly increased the SFR while maintaining a favorable safety profile, suggesting that this integrated approach could offer a more effective treatment pathway for stone expulsion. Further studies in larger, multi-center cohorts are needed for validation.

Aim This study aims to evaluate the effectiveness and safety of administering double-dose tamsulosin (0.8 mg) for treating patients with benign prostatic hyperplasia (BPH) who have not responded to the standard single dose of tamsulosin (0.4 mg) and are deemed unsuitable for transurethral resection (TUR) intervention. Materials and methods Between November 2022 and July 2023, we prospectively analyzed 111 patients who were experiencing severe BPH symptoms. These patients received a double dose of tamsulosin for one month. We collected baseline characteristics such as age, body mass index, and underlying medical conditions. Various parameters including the International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA) levels, prostate volume, peak urinary flow rate (Qmax), voided volume, and post-void residual volume were evaluated before and after treatment. Results All 111 patients completed the study. The mean age, PSA level, and prostate volume were 63.12 ± 4.83 years, 3.42 ± 0.93 ng/ml, and 50.37 ± 19.23 ml, respectively. Of these patients, 93 showed improvement in Qmax, post-void residual volume, and IPSS score ( p -value = 0.001). The total IPSS score and total Qmax improved from 24.03 ± 2.49 and 7.72 ± 1.64 ml/sec to 16.41 ± 3.84 and 12.08 ± 2.37 ml/sec, respectively. Conclusion Double-dose 0.8mg tamsulosin as an alpha-blocker therapy appears to be a viable temporary management option for BPH patients who have not responded to the standard single dose 0.4mg tamsulosin and are not suitable candidates for TUR intervention.

The pathological progression of cirrhosis disrupts the gut-liver axis. ( ) exhibits immunomodulatory properties and an ability to enhance intestinal barrier function. It has been demonstrated that tamsulosin has antifibrotic and anti-inflammatory effects in hepatic injury models. This study evaluated the effect of a tamsulosin and co-treatment on the recovery of microbiota and intestinal barrier integrity in a Wistar rat liver cirrhosis model. Male Wistar rats were administered CCl intraperitoneally for 4 weeks. Subsequently, rats received tamsulosin, , or both, orally for 2 weeks. The intestinal microbiota was assessed using 16S rRNA gene sequencing. Intestinal barrier integrity was evaluated using qPCR and Western blot for proteins ZO-1, occludin, and claudin-2. Bacterial translocation was evaluated by endotoxin concentration, bacterial DNA, and microbial culture of extraintestinal tissues. Finally, hepatic, intestinal histology, and liver function markers were analyzed. and its combination with tamsulosin (T/ ) increased microbial diversity and promoted a balanced gut microbiota characterized by a predominance followed by and reduced and levels. group upregulated ZO-1 and occludin expression, while no significant changes were observed with tamsulosin or T/ groups, nonetheless, intestinal morphology resembled that of healthy controls. Bacterial translocation analysis revealed no endotoxins, bacterial DNA, or bacteria in extraintestinal tissues. Both treatments also improved hepatic and intestinal histology, with partial liver function recovery. Findings such as reduced bacterial translocation, lower systemic endotoxin levels, improved intestinal morphology, and modulation of gut microbiota composition suggest that both agents ( and tamsulosin), particularly in combination, exert positive effects on the intestinal barrier in cirrhosis.

Purpose:To evaluate the effect of delayed start of combination therapy (CT) with dutasteride 0.5 mg and tamsulosin 0.4 mg on the risk of acute urinary retention or benign prostatic hyperplasia (BPH)-related surgery (AUR/S) in patients with moderate-to-severe lower urinary tract symptoms (LUTS) at risk of disease progression.Methods:Using a time-to-event model based on pooled data from 10,238 patients from Phase III/IV dutasteride trials, clinical trial simulations (CTS) were performed to assess the risk of AUR/S up to 48 months in moderate-to-severe LUTS/ BPH patients following immediate and delayed start of CT for those not responding to tamsulosin monotherapy. Simulation scenarios (1 300 subjects/arm) were investigated, including immediate start (reference) and alternative delayed start (six scenarios 1–24 months). AUR/S incidence was described by Kaplan–Meier survival curves and analysed using log-rank test. The cumulative incidence of events as well as the relative and attributable risks were summarised stratified by treatment.Results:Survival curves for patients starting CT at month 1 and 3 did not differ from those who initiated CT immediately. By contrast, significant differences (p < 0.001) were observed when switch to CT occurs ≥ 6 months from the initial treatment. At month 48, AUR/S incidence was 4.6% vs 9.5%, 11.0% and 11.3% in patients receiving immediate CT vs. switchers after 6, 12 and 24 months, respectively.Conclusions:Start of CT before month 6 appears to significantly reduce the risk of AUR/S compared with delayed start by ≥ 6 months. This has implications for the treatment algorithm for men with LUTS/BPH at risk of disease progression.