Can ejaculatory dysfunction be recovered by low-dose tamsulosin in treating patients with symptomatic benign prostatic hyperplasia? – a prospective study

Introduction: Benign prostatic hyperplasia (BPH) is caused by a benign enlargement of the prostate gland. Lower urinary tract symptoms (LUTS) caused by BPH are commonly found among ageing patients. The severity of LUTS are evaluated using the International Prostate Symptom Score (IPSS). Objective: To evaluate the use of low-dose tamsulosin (0.2mg/day) in relieving LUTS related to BPH as a trial to increase drug safety (in terms of reducing full dose side-effects, especially retrograde ejaculation) while maintaining its efficacy in relieving patients’  symptoms. Material and methods: Patients enrolled were suffering from LUTS due to BPH, receiving 0.4mg tamsulosin for variable periods and complaining of ejaculatory dysfunction. During the course of this prospective study (November 2013 to March 2014) 0.2mg tamsulosin was given to the patients. Results: Before we started our treatment with the low dose, 21 patients had a mean IPSS of 7.00±0.948 and mean residual volume of 92.38±20.47ml. At first month follow-up, the mean IPSS and the mean residual volume increased to 7.47±0.67 and 104.76±21.82ml, respectively, a statistically significant difference (P <0.05). Out of 21 patients, 16 patients (76.2%) reported no ejaculation at all and 5 patients (23.8%) reported low ejaculatory volume. After treatment with low-dose tamsulosin, out of 16 patients with no ejaculation, 12 (75%) had recovered and out of the 5 patients who reported low ejaculatory volume, 3 patients (60%) reported increased ejaculatory volume. None of our patients showed adverse effects with the low dose. Conclusion: Low-dose tamsulosin shows potential advantage for patients with bothering ejaculatory dysfunction. In spite of the significant change in IPSS after administration of the low dose, most of these patients showed higher overall satisfaction rate than those receiving the standard dose (0.4mg/day). A prospective study on a larger scale is still needed to confirm our result.