The Effect of Combined Therapy with Tamsulosin Hydrochloride and Meloxicam in Patients with Benign Prostatic Hyperplasia Symptoms and Impact on Nocturia and Sleep Quality

Purpose We aimed to compare the effect and feasibility of a combined therapy with tamsulosin hydrochloride plus meloxicam, and tamsulosin hydrochloride alone in patients with benign prostate hyperplasia symptoms and impact on nocturia and sleep quality. Materials and Methods Four hundred male patients were included in this study between 2008 and 2011. Patients were randomly divided into two groups: one received tamsulosin hydrochloride 0.4 mg (Group 1, 200 patients) and the other tamsulosin hydrochloride 0.4 mg plus meloxicam 15 mg (Group 2, 200 patients) prospectively. Patients were evaluated for benign prostate hyperplasia (BPH) symptoms according to the American Urological Association clinical guidelines and sleep quality according to Pittsburgh Sleep Quality Index (PSQI). Patients were reevaluated after three months of treatment. The International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Qmax), average urinary flow rates (AFR), post void residual urine volumes (PVR), nocturia and Pittsburgh Sleep Quality Score (PSQS) were recorded at baseline and after three months. Results Mean age was 63.3 ± 6.6 and 61.4 ± 7.5 years in groups 1 and 2, respectively (p = 0.245). There were no statistically significant differences between both groups. Also, baseline prostate specific antigen (PSA), prostate volume, creatinine, International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Qmax), average urinary flow rates (AFR), post void residual urine volumes (PVR), nocturia and Pittsburgh Sleep Quality Score (PSQS) were similar in both groups. In addition, the total IPSS, IPSS-QoL, PVR, nocturia, and PSQS were significantly lower in Group 2 compared with Group 1 after treatment (p < 0.05). Qmax and AFR were higher significantly in Group 2 compared with Group 1 after treatment (p < 0.05). Conclusions Cyclooxygenase (COX)-2 inhibitors ...

Effect of Desmopressin in the treatment of refractory nocturia in patients with benign prostatic hyperplasia [BPH]

Nocturia is a common symptom associated with benign Prostatic hyperplasia which can persist even after effective treatment of BPH. Elderly often cite nocturia as one of the most bothersome lower urinary tract symptoms [LUTS]. The aim of this work is evaluating in patients with benign Prostatic hyperplasia [BPH], the effects of a synthetic analogue of vasopressin [Desmopressin] in treatment of refractory nocturia. We investigated 42 patients their ages was ranging between 53 to 77 years [mean 67 years] who were treated for BPH for more than one year and continue to have nocturia of 3 to 10 voiding episodes in the night. This group of patients was treated with Desmopressin 0.2 mg tablet given orally before bedtime for 3 consecutive months and were followed to monitor the effect of this medication on nocturia and to detect any adverse reaction during the study. When compared with the baseline data, the nocturnal urine volume, [641 +/- 265 ml versus 230 +/- 210 ml] and nocturnal frequency [4.9 +/- 1.8 versus 1.1 +/- 0.3] were significantly decreased. They were not observed side effects. We can conclude that Desmopressin is an effective and safe medication to the patients with BPH that they presented a marked nocturia