SOURCE: Zhang HL, et al. Int J Impot Res 2017;29:148-156.
The umbrella term “lower urinary tract symptoms” (LUTS) includes symptoms such as difficulty starting stream, dribbling, incontinence, urgency, and incomplete emptying. In men, the most common source of LUTS is benign prostatic hyperplasia. Alpha-blockers (e.g., tamsulosin, alfuzosin) are employed commonly to treat LUTS in men, based on their capacity to decrease prostatic smooth muscle tone as well as relax the musculature of the bladder neck, which also is rich in alpha-receptors. Individual trials of alpha-blockers in women also have demonstrated improvements in LUTS.
Zhang et al performed a meta-analysis of trials of the efficacy of tamsulosin in women with LUTS (n = 764). They found positive effects on voiding symptoms and quality of life scores. Whereas the typical first-line treatment for women with overactive bladder usually is anticholinergics or beta-3 agonist treatment, these data also showed a favorable effect of tamsulosin on the Overactive Bladder Questionnaire score. Clinicians who are familiar with prescribing tamsulosin probably will recognize that it is generally well tolerated in men. However, long-term safety trials in women have not been conducted. Decades of use of alpha-blockers to treat hypertension in both genders as well as the long-term data of benignity in men reassure clinicians that tamsulosin may be a valuable (though off-label) treatment for LUTS in women.