Long-term tamsulosin treatment (0.4 and 0.8 mg once daily) seems to be effective and well tolerated in patients with neurogenic lower urinary tract dysfunction. The results suggest that it improves bladder storage and emptying, and decreases symptoms of autonomic dysreflexia.

BackgroundSymptoms of depression are common in patients diagnosed with benign prostatic hyperplasia (BPH) and are usually a reaction to deterioration of health, severity of lower urinary tract symptoms, and erectile dysfunction. The aim of this observational study was to evaluate the prevalence of depressive symptoms in patients diagnosed with BPH and factors affecting their occurrence in a large Polish cohort.Patients and methodsFour thousand thirty-five men (4,035) diagnosed with BPH participated in the survey (age 65 ± 8 years). The occurrence of symptoms of depression was assessed using the Beck depression inventory, severity of lower urinary tract symptoms (LUTS) on the basis of the international prostate symptoms score, and erectile dysfunction using the international index of erectile function (IIEF-5).ResultsDepressive symptoms were found in 22.4 % of patients (mild in 20.8 % and moderate/severe in 1.6 %). Erectile dysfunction was found in 71.9 % of patients. Monotherapy for BPH was prescribed to 50.9 % of patients (mostly ARA—selective α1-selective alpha-adrenolytic—47.5 %), while polytherapy (ARA with a 5-alpha reductase inhibitor—5αRI) to 47.9 %. Logistic regression analysis showed a bidirectional relation between the occurrence of depressive symptoms and erectile dysfunction. The occurrence of both depressive symptoms and erectile dysfunction was related to severity of LUTS, nocturia, the use of 5αRI, comorbidity, and sedentary life style.ConclusionsPrevalence of depressive symptoms in patients diagnosed with BPH is associated with severity of LUTS, erectile dysfunction, nocturia, BPH pharmacotherapy (5αRIs), sedentary life style, and comorbidities including obesity.

One hundred patients with benign prostatic hypertrophy (BPH) were randomized to transurethral incision (TUIP) or transurethral resection of the prostate (TURP). The average prostate weight before operation was not more than 30.0 g. Indications for the operations were based on the disease history, physical examination, digital rectal examination, laboratory values, and pressure-flow examination. All operations were performed with patients under spinal anesthesia. TUIP was performed with a Collins knife, and TURP was performed with a resectoscope. Follow-up was performed 24 months after the operations. After treatment there were statistically significant daytime and nocturnal reduction in voiding frequencies of 2.9 and 1.7, respectively, after TUIP, and 2.0 and 1.5 after TURP. In both groups, there occurred significantly better maximal flow rate from 7.6 mL/s to 16.9 mL/s in group I and from 6.9 mL/s to 17.6 mL/s in group II. The mean values of linearized passive urethral resistance relation in both groups significantly decreased from 3.6 +/- 0.6 to 1.0 +/- 0.5 after TUIP and from 3.9 +/- 04 to 1.4 +/- 0.5 after TURP. The TUIP procedure is effective and safe for patients with a small number of complications.

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This study presents long-term results of treatment of urethral strictures in 178 men who underwent direct vision cold urethrotomy between January 1, 1979 and December 31, 1984. Satisfactory urodynamic results were achieved in 69.7% of cases.