COMPARISON OF EFFECTIVENESS OF MELOXICAM 15 MG ONLY, COMBINATION OF MELOXICAM 15 MG AND TAMSULOSIN 0.4 MG, AND TAMSULOSIN 0.4 MG ONLY FOR SUCCESS OF TWOC IN BPH PATIENTS WITH FIRST EPISODE OF ACUTE URINARY RETENTION
Objective: To prove that Meloxicam 15 mg only, combination of Meloxicam 15 mg and Tamsulosin 0.4 mg were more effective for the success of Trial Without Catheter (TWOC) in BPH patients with first episode of urinary retention compared to Tamsulosin 0.4 mg only. Material & methods: Benign Prostatic Hyperplasia (BPH) patients with first episode of urinary retention that met the inclusion criteria and did not fulfill the exclusion criteria were randomized to form 3 treatment groups, n=11 for each group. Group I was given Meloxicam 15 mg only, group II was given a combination of Meloxicam 15 mg and Tamsulosin 0.4 mg, and group III was given Tamsulosin 0.4 mg only. For each group the drug given once orally for 7 days. The success of TWOC assessed by an ability to spontaneous micturition after that each treatment in the first 24 hours after urethral catheter removal, accompanied by Qmax in uroflowmetry ≥ 5 cc/sec and PVR ≤ 100 cc. Results: All Meloxicam 15 mg only group samples have recurred urinary retention (100%). The success rate of TWOC for combination of Meloxicam 15 mg and Tamsulosin 0.4 mg group was 72.7%; while for the Tamsulosin 0.4 mg only one was 63.6%. The success rate of TWOC for combination of Meloxicam 15 mg and Tamsulosin 0.4 mg group was higher than Tamsulosin 0.4 mg only one (p=0.003). Conclusion: The combination of Meloxicam 15 mg and Tamsulosin 0.4 mg orally once daily for 7 days was more effective in the success of TWOC in BPH patients with first episode of urinary retention compared to Tamsulosin 0.4 mg only orally once daily for 7 days.
Garraway WM, Collins GN, Lee RJ. High prevalence of prostatic hypertrophy in the community. Lancet. 1991; 338: 469−71.
Briganti A. Benign prostatic hyperplasia and its aetiology. Eur Urol. 2009; 8: 865−71.
Nickel JC, Roehrborn CG, Castro-Santamaria R, Freedland SJ, Moreira DM. Chronic prostate inflammation is associated with severity and progression of benign prostatic hyperplasia, lower urinary tract symptoms, and risk of acute urinary retention. The Journal of Urology; 2016.
Gandaglia G. The role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH). BJU Int. 2013; 112(4): 432−41.
Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, et al. Natural history of prostatism: Risk factors for acute urinary retention. J Urol. 1997; 158: 481−7.
Fitzpatrick JM. Management of acute urinary retention: A worldwide survey of 6074 men with benign prostatic hyperplasia. BJU Int. 2011; 109: 88−95.
McNeill SA. The role of alpha-blockers in the management of acute urinary retention caused by benign prostatic obstruction. Eur Urol. 2004; 45: 325−32.
Guang-Jun D, Feng-Bin G, Xun-Bo J. α1-blockers in the management of acute urinary retention secondary to benign prostatic hyperplasia: A systematic review and meta-analysis. Ir J Med Sci. 2014; 184(1): 23−30.
Maldonado-Avila M. A comparative study on the use of tamsulosin versus alfuzosin in spontaneous micturition recovery after transurethral catheter removal in patients with benign prostatic growth. Int Urol Nephrol. 2014; 46: 687−90.
Roehrborn CG. Benign prostatic hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In: Campbell-Walsh Urology, 10th ed. Philadelphia: Elsevier Saunders. 2012; 10: 2570−610.
Tuncel A, Uzun B, Eruyar T, Karabulut E, Seckin S, Atan A. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention? Eur Urol. 2005; 48: 277−84.
Falahatkar S, Mokhtari G, Pourreza F, Asgari SA, Kamran AN. Celecoxib for treatment of nocturia caused by benign prostatic hyperplasia: A prospective, randomized, double-blind, placebo-controlled study. Urology. 2008; 72(4): 813−6.
Ozdemir I, Bozkurt O, Demir O, Aslan G, Esen AA. Combination therapy with doxazosin and tenoxicam for the management of lower urinary tract symptoms. Urology. 2009; 74(2): 431−5.
Suarsana W, Hardjowijoto S, Soetojo, Budiono. Doxazosin and meloxicam combination therapy for BPH treatment with LUTS. Indonesian J of Urol. 2014; 21(1): 27−32.
Chen JS, Chang CH, Yang WH, Kao YH. Acute urinary retention increases the risk of complications after transurethral resection of the prostate: A population based-study. BJU Int. 2012; 110: 896−901.
Bowden E, Hall S, Foley SJ, Rundle JSH. Tamsulosin in the treatment of urinary retention: A prospective, placebo-controlled trial. BJU Int. 2001; 88(1): 77.
Lucas MG, Stephenson TP, Vinod N. Tamsulosin in the management of patients in acute urinary retention from benign prostatic hyperplasia. BJU Int. 2005; 95: 354−7.
Kahokehr A, Vather R, Nixon A, Hill AG. Non-steroidal anti-inflammatory drugs for lower urinary tract symptoms in benign prostatic hyperplasia: Systematic review and meta-analysis of randomized controlled trials. BJU Int. 2013; 111(2): 304−11.
Ozdemir I, Bozkurt O, Demir O, Aslan G, Esen AA. Combination therapy with Doxazosin and Tenoxicam for the management of lower urinary tract symptoms. Urology. 2009; 74: 431−5.
Di Silverio F. Combination therapy with rofecoxib and finasteride in the treatment of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Eur Urol. 2005; 47(1): 72−8.
Gorgel SN, Sefik E, Kose O, Olgunelma V, Sahin E. The effect of combined therapy with Tamsulosin hydrochloride and Meloxicam in patients with benign prostatic hyperplasia symptoms and impact on nocturia and sleep quality. Int Braz J Urol. 2013; 39: 657−62.
Kirschenbaum A. Expression of cyclooxygenase-1 and cyclooxygenase-2 in the human prostate. Urology. 2000; 56(4): 671−6.
Lee L-M, Pan C-C, Cheng C-J, Chi C-W, Liu T-Y. Expression of cyclooxygenase-2 in prostate adenocarcinoma and benign prostatic hyperplasia. Anticancer Research. 2001; 21(2): 1291−4.
Wang W, Bergh A, Damber J-E. Chronic inflammation in benign prostate hyperplasia is associated with focal upregulation of cyclooxygenase-2, Bcl-2, and cell proliferation in the glandular epithelium. The Prostate. 2004; 61(1): 60−72.
Verhamme KM. Nonsteroidal anti-inflammatory drugs and increased risk of acute urinary retention. Arch Intern Med. 2005; 165(13): 1547−51.
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