Combination of tolterodine and tamsulosin for benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>Overactive bladder may coexist with bladder outlet obstruction induced by benign prostatic hyperplasia (BPH). This study aimed to evaluate the efficacy of the combined use of tolterodine and tamsulosin in the treatment of BPH accompanied by overactive bladder.</p><p><b>METHODS</b>We selected 53 cases of clinically diagnosed BPH, and randomly assigned them to a tamsulosin group (n = 25) to receive 0.2 mg of tamsulosin once a day and a tamsulosin + tolterodine group (n = 28) to be treated with 0.2 mg of tamsulosin once a day plus 2 mg of tolterodine twice a day, both for 12 weeks. Before and after the treatment, we obtained the International Prostate Symptoms Score (IPSS), quality of life (QOL) score and Qmax, and recorded the adverse events.</p><p><b>RESULTS</b>All the patients accomplished the 12-week treatment. The tamsulosin group showed a significant decrease in IPSS and QOL from 21.50 +/- 5.42 and 4.58 +/- 0.94 before the treatment to 14.80 +/- 4.21 and 2.78 +/- 0.91 after it (P < 0.05), but a significant increase in Qmax from (12.20 +/- 6.60) ml/s to (16.40 +/- 5.13) ml/s (P < 0.05). In the tamsulosin + tolterodine group, IPSS and QOL were decreased from 20.90 +/- 5.15 and 4.61 +/- 0.86 at the baseline to 14.90 +/- 5.32 and 2.12 +/- 0.87 after the medication (P < 0.05), Qmax was increased from (13.30 +/- 7.80) ml/s to (16.70 +/- 6.32) ml/s (P < 0.05), and the score on the urinary storage phase symptoms was reduced from 10.12 +/- 3.10 to 4.77 +/- 0.75 (P < 0.05).</p><p><b>CONCLUSION</b>Tamsulosin could quickly relieve BPH-induced lower urinary tract symptoms (LUTS) , while the combined use of tolterodine and tamsulosin could even better alleviate the LUTS and improve the QOL of BPH patients.</p>

Plasmakinetic transurethral resection of the prostate: Complications and management thereof / 中国微创外科杂志

Objective To study the complications and their management of plasmakinetic transurethral resection of the prostate (PKRP). Methods Complications and their management of 51 cases of PKRP from May 2003 to June 2006 were retrospectively reviewed. Results Complications of the procedure were as follows. Bladder spasms occurred in 27 cases (accompanying hemorrhage in 2 cases and urge incontinence in 6 cases), and the symptoms disappeared after patient-controlled intravenous analgesia and M-receptor blocker (tolterodine). Postoperative bleeding occurred in 6 cases. Continuous irrigation with normal saline and medical therapy were given in 3 cases, and open surgery was required in 3 cases with severe bleeding. All bleeding patients obtained a full recovery of voiding function without re-bleeding. Urge incontinence occurred in 13 cases, and was cured with functional exercises of pelvic floor muscles and M-receptor blocker (tolterodine) administration. Stress incontinence was observed in 1 case, and a penile clamp had been used to control incontinence. Among 7 cases of urinary retention after operation, a re-operation of PKRP was conducted in 2 cases and oral medication was carried out in 5. The voiding function recovered well in all the 7 cases. In 5 cases of urethral stricture, urethral dilatation was employed in 3 cases and urethrotomy was performed in 2 cases to obtain a good recovery of voiding function. Conclusions Bladder spasm, postoperative bleeding, incontinence, urinary retention, and urethral stricture are common complications of PKRP. Strict adherence to technique and timely and proper management of complications are considered essential to improve results.