A Pilot Study to Investigate the Use of Tamsulosin in Women with Lower Urinary Tract Symptoms

Hypothesis / aims of study: Lower urinary tract symptoms (LUTS) are common in women. Although many women have primarily storage symptoms, others have a combination of storage and voiding symptoms without having a defined mechanical obstruction. Anti-muscarinic drugs are commonly used to treat women with LUTS whether they have primarily storage or storage and voiding symptoms. It is doubtful that anti-muscarinics improve voiding symptoms, and may actually worsen such symptoms. It has been postulated that alpha-blockers may help in women with LUTS if the predominant symptoms are voiding related. This may be due to bladder neck relaxation as has been shown in children or due to other yet not well defined mechanisms. Previous small scale studies have been equivocal and larger randomized controlled trials have not been performed. Tamsulosin, an alpha 1 a,d subtype selective alpha blocker with minimal side-effects and an excellent safety profile, has anecdotally been noted to improve such symptoms in women. At the time of this study, no validated female LUTS questionnaires were available, and thus the the American Urological Association symptom index was used as it best divided symptoms between storage and voiding. This randomized, double-blinded, placebo-controlled study compared the symptomatic improvement afforded by tamsulosin vs. placebo in female LUTS with a significant component of voiding symptoms.