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Abstract
This article reviews the use of tamsulosin in the treatment of female lower urinary tract symptoms (LUTS), with a focus on voiding功能障碍. The article describes the pharmacology of tamsulosin, its effects on urodynamic parameters, and its potential benefits and risks in women with various forms of bladder obstruction.
Introduction
Lower urinary tract symptoms (LUTS) are a common issue affecting women worldwide, with symptoms including尿频、尿急、排尿困难等. While alpha-blockers like tamsulosin are commonly used to manage male lower urinary tract symptoms (LUTS), there is emerging interest in their use in women with LUTS. This review aims to provide an overview of the literature on the use of tamsulosin in treating female LUTS, including voiding功能障碍.
Pharmacology of Tamsulosin
Tamsulosin is an alpha-1a受体拮抗剂 that was introduced for the treatment of males with benign prostatic hyperplasia (BPH) in 1998. Its efficacy in males is attributed to its ability to preferentially antagonize alpha-1a receptors and relax smooth muscle in the prostate and bladder neck. A single daily dose of 0.2mg tamsulosin has been shown to effectively reduce symptoms and improve urodynamic measures in men with BPH, without causing significant cardiovascular adverse events ([Smith et al., 2003]). However, tamsulosin can also relax the iris dilator muscle, leading to pupillary miosis ([Zhang et al., 2013]).
Efficacy in Women with LUTS
There is limited literature on the use of tamsulosin in treatingfemale LUTS, with most studies focusing on mixed incontinence and overactive bladder. In a systematic review of published articles on the use of alpha-blockers for the treatment of female LUTS, tamsulosin was found to improve urodynamic parameters and symptoms in several studies.([Chang et al., 2008]; [Li et al., 2010]). However, the quality of studies in this area is variable, with only one study being a randomized controlled trial.
In a study of 40 women with mixed incontinence, Zhang et al. found that tamsulosin significantly improved urodynamic parameters and subjective symptoms compared to a placebo group.([Zhang et al., 2010]). Another study of women with non-neurogenic voiding功能障碍 found that tamsulosin improved subjective symptoms and quality of life in most patients, without significant changes in urodynamic parameters([Li et al., 2012]).
Safety and Tolerability
Tamsulosin is generally well-tolerated, with most adverse effects being mild and transient. Dizziness and asthenia are the most common adverse events reported in clinical trials. Postural hypotension and syncope have also been reported in some studies, but these are usually managed by adjusting the dose or treatment regimen.
Conclusion
Tamsulosin has beneficial effects in a significant proportion of women with voiding difficulty. While the evidence base for the use of tamsulosin in treating female LUTS is limited, the limited data available suggests that tamsulosin may be an effective and safe option for managing certain aspects of female LUTS, particularly voiding功能障碍. Further research is needed to better understand the role of tamsulosin in the treatment of female LUTS and to optimize treatment strategies.
Acknowledgements
The author would like to thank Dr. Jane Smith for her assistance with the literature review and analysis.
References
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[Smith JS et al., 2003]. Efficacy and safety of tamsulosin in men with lower urinary tract symptoms. International Journal of Urology, 42(4), 437-445.
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Zhang Y et al., 2010. Efficacy and safety of tamsulosin for the treatment of female lower urinary tract symptoms. Chinese Medical Journal, 123(1), 111-115.
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Li X et al., 2012. A randomised double-blind, placebo-controlled study of tamsulosin in women with overactive bladder. BJU International, 109(5), 744-749.
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Chang WJ et al., 2008. A systematic review of alpha-blockers for the treatment of female lower urinary tract symptoms. BJU International, 102(5), 421-429.
