Recovery Of Abnormal Ejaculation By Intermittent Tamsulosin Treatment

Main Category: Urology / Nephrology
Also Included In: Erectile Dysfunction / Premature Ejaculation;  Men's health
Article Date: 01 Mar 2006 - 4:00 PDT

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UroToday.com - Alpha-blockade continues to be the predominant form of medical therapy for symptomatic bladder outlet obstruction due to BPH. Three alpha 1-adrenoreceptor subtypes have been identified in pharmacological studies, namely alpha-1A, alpha-1B and alpha-1D. Tamsulosin is the first selective alpha-1A adrenoreceptor antagonist in contrast to the non-selective blockers alfuzosin, terazosin and doxazosin. Regardless of the agent used, the current literature advocates continued alpha-blocker use for the effect to be maintained.

In a recent study by Goktas and colleagues from Ankara, Turkey, the ability of the intermittent use of tamsulosin was examined for efficacy and for the known side effect of abnormal ejaculation. The study is published in the February 2006 issue of the Journal of Urology. In a previous report, the authors showed that 0.4 mg of tamsulosin given every other day had comparable improvements in urinary flow and symptoms to tamsulosin taken every day. In this recent prospective study, the authors investigated whether retrograde ejaculation decreases with intermittent therapy.

The study included 405 patients of at least 50 years old with LUTS secondary to BPH. In the two phases of the study, the patients received 0.4 mg of tamsulosin each day after breakfast for 3 months then the 30 patients who experienced abnormal ejaculation were given the drug every other day. Patients were assessed at study entry and at study week 6.

The results showed that before intermittent treatment, the mean IPSS was 7.6, mean Qmax was 11.7 ml/sec, and mean residual volume was 73.9 cc in the men who experienced abnormal ejaculation. At study week 6 these values were 7.5, 11.6 ml/sec, and 72.7 cc. These mild decreases were not statistically significant.

A total of 30 patients (7.3%) had treatment emergent abnormal ejaculation. Abnormal ejaculation was noted to be retrograde ejaculation in 18 of the 30 patients, and decreased volume or absent ejaculate in 12 patients. Ejaculatory function was noted to recover in during intermittent tamsulosin therapy in 19 of 30 cases (63%). Specifically, a statistically significant improvement in retrograde ejaculation was seen with 12 of 18 patients no longer experiencing this symptom once every other day dosing was initiated.

This study can help clinicians handle the worrisome side effect of ejaculatory dysfunction in men on tamsulosin therapy by merely decreasing the frequency of intake of the medicine without compromising improvements in LUTS.

Written By Michael J. Metro, MD

Reference:

J Urol. 2006 Feb; 175(2):650-53

Link Here.

Goktas S, Kibar Y, Kilic S, Topac H, Coban H, Seckin B

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