INTRODUCTION: Tumor recurrence following nephron-sparing surgery (NSS) for renal carcinoma is a major concern. The aim of this retrospective study was to assess the rate, patterns, and predictors of tumor recurrence in patients following NSS for renal cancer.

METHODS: Between 1993 and 2008, 229 patients underwent NSS via flank incision for renal cell carcinoma. Patients without metastases at diagnosis (using CT and bone scan) were included in the outcome analysis. Categorical variables were compared with the Fisher-Irwin exact test. Kaplan-Meier was used to determine the probability of overall survival and probability of recurrence curves; significance was tested with the log-rank. The Cox hazard survival model was used to identify whether any of the demographic or clinical variables were predictive of the probability of recurrence.

RESULTS: During a mean (SD) follow-up time of 45 (34) months, tumor recurrence was observed in 13 patients (5.6%). Mean follow-up time for detection of oncological failure was 51 months. All patients with oncological failure were males, with a mean age of 61 years (median 58; range, 51-74 years). The average size of the enucleated lesion was 5 cm (range, 4-7 cm). Intraoperative frozen sections and postoperative pathological examination of the surgical margins were negative in all cases. Predictors of oncological failure included: warm ischemia time > 20 minutes (P = .012), tumor size ≥ 4 cm (P = .001), central tumor location (P = .015), multifocal tumors (P = .001), and male gender (P = .01). The probability of overall disease recurrence at 12 and 60 months was 1.8% and 4.0%, respectively. The overall cancer-specific survival rate was 93.8%. The 12-month and 60-month metastasis-free survival rates were 99.1% and 98.4%, respectively. Recurrence was due to surgeon-related and tumor-related patterns.

CONCLUSIONS: NSS is an effective surgery with satisfactory long-term cancer control. Predictors of recurrence were consistent with previous literature except for warm ischemia time > 20 minutes (noted for the first time). Reasons for cancer relapse include seeding during surgery, residual disease, distant dissemination, and new tumor growth. Careful tumor handling and extensive perirenal fat resection are within the surgeon's control and may reduce failure rates.

KEYWORDS: Renal cell carcinoma; Nephron-sparing surgery; Cancer recurrence.

CORRESPONDENCE: CORRESPONDENCE: Sarel Halachmi MD, Department of Urology, Bnai Zion Medical Center, 47 Golomb St. 31048, Haifa, Israel ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: Urotoday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.12.17

ABBREVIATIONS AND ACRONYMS: NSS, nephron-sparing surgery; RCC, renal cell carcinoma.

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A 55-year-old female presented with recurrent hematuria and urinary tract infections. Evaluations with computed tomography urogram, flexible cystoscopy, and urine cytology revealed an extensive bladder tumor with a vesicovaginal fistula. The TNM pathologic stage of the tumor was pT3a N0 M0. Histological evaluation showed that there were cohesive epithelioid malignant cells suggestive of urothelial carcinoma in few areas. However, most of the neoplasm consisted of singly dispersed cells with eccentric, abundant eosinophilic cytoplasm and bizarre, spindly nuclei characteristic of sarcomatoid urothelial carcinoma (SUC). The patient had anterior pelvic exenteration and adjuvant chemotherapy. No evidence of metastasis was found in preoperative or postoperative imaging. However, the patient presented with a rare axillary mass 3 months after surgery. Biopsy of the mass showed sarcomatous differentiation similar to the SUC primary tumor in the bladder. A CT scan of the chest and a whole body scan revealed lung, liver, abdominal, and mesenteric lymph node metastases. She died approximately 6 months after the initial diagnosis. The authors compare this case of axillary metastasis from sarcomatoid variant of urothelial cancer with other reports in the literature.

KEYWORDS: Sarcomatoid urothelial carcinoma; Axillary metastasis; Survival rate.

CORRESPONDENCE: Dr. Satya Allaparthi, Department of Surgery, University of Massachusetts Medical School, S4868, Division of Urology, 55 Lake Avenue North, Worcester 01655, MA ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.01

ABBREVIATIONS AND ACRONYMS: CS, carcinosarcoma; CT, computed tomography; SUC, sarcomatoid urothelial carcinoma; TCC, transitional cell carcinoma; UC, urothelial carcinoma.

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A 30-year female with history of ulcerative colitis and partial colectomy presented with rectal bleeding and fecal and urinary incontinence. She had active colitis with granulation tissue, crypt abscess formation, extensive regenerative changes, and lymphoid aggregate formation. She also had a contracted bladder and vesicovaginal fistula. She underwent total proctocolectomy and cystectomy. Simultaneous urinary and fecal diversion was achieved with a double-barreled wet ileostomy (DBWI). The anterior pelvic exenteration was technically challenging secondary to prior surgery, but no major complications were encountered. This is the second known reported case following development of the DBWI technique in 2005. The case shows that DBWI can be safely performed after total colectomy and pelvic exenteration, with no serious complications or morbidity in the first 19 months. This technique may be particularly advantageous for patients with fistulous intestinal tracts.

KEYWORDS: Pelvic exenteration; Urinary diversion

CORRESPONDENCE: Sertac Yazici, MD, Hacettepe University School of Medicine, Department of Urology, Sihhiye, Ankara 06100, Turkey ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: Urotoday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.02

ABBREVIATIONS AND ACRONYMS: DBWI, double-barreled wet ileostomy; UC, ulcerative colitis.

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Reports from the World Health Organization estimate that nearly one third of the world's population is infected with Mycobacterium tuberculosis. The present case is a 33-year-old woman who was pregnant in the first trimester. She presented with mild fever and left flank pain and was treated for renal abscess. Postpartum investigations revealed renal tuberculosis (TB), necessitating medical treatment and open surgery drainage. The diagnosis of genitourinary TB is difficult because its symptoms are nonspecific, but early diagnosis is essential for successful management. Screening of TB should be considered for the following groups of pregnant women: (1) patients with symptoms suggestive of TB; (2) patients with HIV infection; (3) patients who were in close contact with infectious TB; and (4) patients who recently visited countries with high TB-prevalence. The authors report the case with a review of the literature.

KEYWORDS: Genitourinary tuberculosis; Pregnancy; Abscess.

CORRESPONDENCE: Dr. Sataa Sallami, Department of Urology, La Rabta Hospital-University, Tunis 1007, Tunisia ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.05

ABBREVIATIONS AND ACRONYMS: ESR, erythrocyte sedimentation rate; GUTB, genitourinary tuberculosis; M. tuberculosis, Mycobacterium tuberculosis; TB, tuberculosis; WHO, World Health Organization.

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Wilms tumor is rare in adulthood. The prognosis is poor when compared with children. Adults more frequently present with advanced disease stages, and chemotherapy has a moderate effect. The various protocols of chemotherapy and indications for surgery and radiotherapy are not yet precisely defined, mainly due to the rarity of the disease. The Society of Pediatric Oncology (SIOP) guidelines suggest that both pediatric and adult patients should have initial chemotherapy followed by surgery. However, the National Wilms Tumor Stage Group (NWTSG) recommends surgery followed by chemotherapy. The authors present 2 cases of adult nephroblastoma that were highly resistant to presurgical chemotherapy. Nephrectomy was not completed because of rapid disease progression. The poor response of these 2 patients indicates that the alternate NTWSG approach of initial surgery followed by systemic treatment might have better results for this population. The authors review related reports and discuss the diagnosis and management of adult Wilms tumor.

KEYWORDS: Adult Wilms tumor; Prognostic factors; Management.

CORRESPONDENCE: Samia Arifi, MD, Department of Medical Oncology, Hassan II University Hospital, Route Sidi Harazem, Fez, Morocco ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: Urotoday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.04

ABBREVIATIONS AND ACRONYMS: AWT, adult Wilms tumor; CT, computed tomography; NWTSG, National Wilms Tumor Stage Group; OS, overall survival; PNET, primitive neuroendocrine tumors; PWT, pediatric Wilms tumor; SIOP, Society of Pediatric Oncology; VOD, venoocclusive disease.

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Emphysematous pyelitis (EP) is a rare infection of the urinary collecting system due to gas-forming bacteria. It is an uncommon form of acute pyelonephritis that has been reported sporadically in the literature. The present case of EP was complicated by renal calculi. The patient had surgery to remove the calculi 4 months after the initial diagnosis. During the 4-month interim between diagnosis and surgery, she had no antibiotic therapy. A presurgical CT showed the same stone burden with no evidence of abscess. There was a complete resolution of gas in the collecting system. At the 6-month follow-up evaluation, the patient was asymptomatic and the kidney remained stone-free.

KEYWORDS: Emphysematous pyelitis; Calculi; CT scan.

CORRESPONDENCE: Dr. Sataa Sallami, Department of Urology, La Rabta Hospital-University, Tunis 1007, Tunisia ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.10

ABBREVIATIONS AND ACRONYMS: CT, computed tomography; EP, emphysematous pyelitis; EPN, emphysematous pyelonephritis; KUB, kidney, ureter, bladder.

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INTRODUCTION: Controversy remains as to the value of digital rectal examination (DRE) for detecting prostate cancer in men presenting with lower urinary tract symptoms and low prostate-specific antigen (PSA) levels. The purposes of the present retrospective investigation were to: (1) evaluate the positive predictive value (PPV) of an abnormal DRE in patients with PSA < 3 ng/mL, (2) describe the stage and grade of the cancers detected, and (3) describe the treatment modalities used for patients at each clinical stage.

METHODS: A prospectively maintained prostate biopsy service database of consecutive men undergoing prostate biopsies from April 2004 to April 2006 was reviewed. Patients with PSA < 3 ng/mL and definitely abnormal DRE were divided into 3 groups according to PSA range. The relationship between abnormal DRE and positive prostate biopsy was determined. The International Prostate Symptom Score (IPSS), clinicopathologic features of prostate cancer, and the treatments used for each clinical stage were summarized.

RESULTS: From 1235 men who underwent prostate biopsies, 59 (4.6%) had PSA < 3 ng/mL and an abnormal DRE. Their mean age was 63.4 years. Fifteen of the 59 patients had true-positive DRE; 44 patients had false-positive DRE. The PPV of an abnormal DRE for detecting prostate cancer was 25.4%. The incidence of prostate cancer was 13.3%, 33%, and 53.3% in patients with abnormal DRE and PSA levels of 0.1-1.0 ng/mL, 1.1-2.0 ng/mL, and 2.1-2.9 ng/mL, respectively. Patients with significant LUTS (IPSS > 19) were likely to have false-positive DREs (P = .019). Patients with mild LUTS (IPSS < 7) and abnormal DREs tended to have positive prostate biopsies (P = .030). Modalities used to treat the 15 patients with cancer included active monitoring, brachytherapy, and external beam radiotherapy in 3 (20%), 5 (33.3%) and 4 (26.6%) patients, respectively. Hormonal deprivation was used for 1 patient; radical prostatectomy was used for 2 patients.

CONCLUSIONS: DRE has a significant role in detecting prostate cancer in men presenting with PSA < 3 ng/mL. The higher the PSA, the greater the possibility of detecting prostate cancer in this selective cohort.

KEYWORDS: Digital rectal examination; Low PSA; Prostate cancer diagnosis

CORRESPONDENCE: Michael Nomikos MD, FEBU, Consultant Urologist, Knossou 275, Heraklion, Crete, 71409,Greece ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: Urotoday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.07

ABBREVIATIONS AND ACRONYMS: DRE, digital rectal examination; GP, general practitioner; IPSS, International Prostate Symptom Score; LUTS, lower urinary tract symptoms; PPV, positive predictive value; TRUS, transrectal ultrasound.

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INTRODUCTION: The assessment of creatine kinase (CK) in human sperm cells is an unbiased indicator of sperm maturity and fertilization potential. Elevated CK values are associated with an increased number of functional abnormalities and increased cytoplasmic residues. The CK-Mi isoenzyme in human sperm is of mitochondrial origin. Increased spermatozoal CK activity is associated with high CK cell levels. The objective of the present study was to compare the biochemical marker CK with morphological changes of the head, neck, and tail. The authors also investigated the assessment of CK activity in human sperm to obtain an objective biochemical marker of sperm maturity and fertilization potential.

METHODS: The activity of CK was assessed for seminal plasma-deprived spermatozoa in 126 men. The participants were divided into 2 groups. Patients in group 1 (n = 64) had reduced spermatozoa count. They were subdivided into: group 1a (n = 28) patients with moderate oligospermic characteristics (spermatozoa count 5.1 - 20 x 10⁶/mL), and group 1b (n = 36) patients with severe oligospermic characteristics (spermatozoa count < 5 x 10⁶/mL). Group 2 (n = 62) was a comparison group of patients with normospermic characteristics (spermatozoa count > 20 x 10⁶/mL; motility > 0.30). Semen analysis was performed according to World Health Organization guidelines. The CK-Mi isoenzyme was separated from CK-B using DEAE Sephadex™ A-50 columns, and agarose gel electrophoresis was used for separating the CK-Mi isoenzyme. The total CK activity was assessed with a spectrophotometer.

RESULTS: CK was significantly higher in the group with severe oligospermia (mean [SD] = 1.9 [2.2] UI/10⁸ sperm cells) than in the group with normospermia (0.097 [0.026] UI/10⁸ sperm cells) (P < .01). The group with oligospermia had a significantly lower CK-Mi/CK ratio (0.16 [0.10]) than the group with normospermia (0.36 [0.12]) (P = < .01).

DISCUSSION: The concentration of CK and synthesis of CK-Mi isoforms reflect normal spermatogenesis and can be used for predicting human sperm maturity and fertilization potential. CK appears to be a sensitive indicator of spermatozoa quality and maturity for men with male-factor infertility.

KEYWORDS: Oligospermia; Normospermia; Creatine kinase; Isoenzyme CK-Mi

CORRESPONDENCE: Professor Sava Micic, MD, PhD, Institute of Urology and Nephrology, Resavska 51, Belgrade 11000, Serbia ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.08

ABBREVIATIONS AND ACRONYMS: CK, creatine kinase; CK-Mi, CK of mitochondrial origin.

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A bifid blind-ending ureter is an extremely rare congenital anomaly of the upper urinary tract. Lithiasis inside the blind-ending branch has only been reported in a few cases. This unusual ureteric condition appears to be most common in female patients. A 53-year-old woman was admitted with right lumbar colic pain. A kidney-ureter-bladder X-ray revealed a spherical radiopaque shadow, projected on the right side of the sacrum in the region of the lower third of the right ureter. An intravenous pyelography showed a distal stone in the right ureter, with mild hydronephrosis and a hydroureter. Ureteroscopy and retrograde pyelography revealed a right blind-ending bifid ureter. The blind-ending branch, originating in the distal third of the ureter, contained a stone that caused obstruction of the normal branch. The stone was treated with endoscopic lithotripsy. At the 3-month follow-up evaluation, the patient was stone-free and asymptomtic. The clinical significance of this malformation is discussed in light of the current literature.

KEYWORDS: Blind-ending ureter; Bifid ureter; Abnormalities; Intravenous urography; Ureter; Calculus.

CORRESPONDENCE: Dr. Sataa Sallami, Department of Urology, La Rabta Hospital-University, Tunis 1007, Tunisia ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: Urotoday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.11

ABBREVIATIONS AND ACRONYMS: IVU, intravenous urography; RP, retrograde pyelography.

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Prostatitis is the name given to a group of disorders that share surprisingly little in the way of etiology, symptoms, and treatment. Frequently, the diagnosis and management of these conditions is empiric, inadequate, ineffective, and contrary to the published literature of the past 10 years. In the present commentary, 23 "theses" are presented as a plea to physicians managing these patients to modify their ingrained approaches and incorporate simple evidence-based changes that can greatly improve outcomes and patient quality of life.

KEYWORDS: Prostatitis; Chronic pelvic pain syndrome

CORRESPONDENCE: Daniel Shoskes, MD, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Desk Q10-1, Cleveland, Ohio, 44195, USA ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.11

ABBREVIATIONS AND ACRONYMS: GU, genitourinary; LUTS, lower urinary tract symptoms; NIH, National Institutes of Health; PSA, prostate-specific antigen; UTI, urinary tract infection.

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Inverted papilloma (IP) of the urinary tract is an uncommon tumor that is usually regarded as benign. The exact cause of IP is presently unknown, although various theories have been postulated. It typically occurs during the fifth or sixth decade of life. Although IP has been reported in the pediatric age group, its occurrence in a young female during pregnancy has never been reported. The present case is a 24-year-old female who presented with gross hematuria in the 16th week of pregnancy. She had IP of the urinary bladder with extensive squamous metaplasia. Immunohistochemistry showed positivity with human papillomavirus strain 16. Transurethral resection of the bladder tumor was completed and there was no recurrence 16 months later. Squamous metaplasia has been defined as a diagnostic feature of IP, but its extensive presence during pregnancy raises questions about the influence of hormones on its development.

KEYWORDS: Inverted Papilloma; Pregnancy; Squamous metaplasia; Urinary bladder

CORRESPONDENCE: Dr. Punit Tiwari, Department of Urology, Institute of Post Graduate Medical Education and Research, SSKM Hospital, 242, AJC Bose Road, Kolkata, West Bengal, 700020, India ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: Urotoday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.13

ABBREVIATIONS AND ACRONYMS: HPV, human papillomavirus; IP, inverted papilloma

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A vesical calculus weighing more than 100 g is categorized as a giant urinary bladder stone. Male preponderance for urinary bladder calculi is well known. A rare case of a giant bladder calculus weighing 565 g and occurring in a female patient is reported. The stone was removed by open cystolithotomy. Possible etiological factors are discussed, some of which are unique to this case.

KEYWORDS:Urinary bladder; Infection; Stone; Surgery

CORRESPONDENCE: Dr Rikki Singal, c/o Dr Kundan Lal Hospital, Ahmedgarh, Distt-Sangrur, 148021, Punjab, India ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: Urotoday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.15

ABBREVIATIONS AND ACRONYMS: UTI, urinary tract infection.

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INTRODUCTION: The purpose of the present study was to compare the outcomes of patients receiving sequential chemoimmunotherapy using mitomycin (MMC) and bacillus Calmette-Guerin (BCG) with the outcomes of patients receiving BCG alone for the treatment of recurrent superficial bladder tumors.

METHODS: A total of 56 patients with recurrent Ta or T1 bladder tumors were enrolled in this prospective randomized study. Group 1 (n = 29 patients) received MMC instillation immediately after resection followed by weekly instillation for 4 weeks. Patients then received BCG monthly for 1 year. Group 2 (n = 27) received only BCG, instilled weekly for 6 weeks and then monthly for 1 year.

RESULTS: There was a significant treatment effect for both groups, as indicated by a reduction in mean recurrence rate and recurrence index (P = .001). However, the difference in recurrence rate and recurrence index distributions after treatment was significant in favor of group 1. The mean follow-up period was 24 months (range, 3-30 months). Recurrent tumors were found in 9 patients (31%) in group 1 and 16 patients (70%) in group 2 at the end of the follow-up period. Kaplan-Meier estimates were significantly different throughout the follow-up period. MMC followed by monthly BCG was significantly superior to BCG in the time to initial recurrence (log rank (P < .0024).

CONCLUSIONS: Patients receiving BCG single-agent immunotherapy and patients receiving sequential chemoimmunotherapy using MMC instillations followed by monthly BCG instillation both had significant treatment effects. However, the difference in recurrence rate and recurrence index distributions after treatment was significant in favor of the group receiving the sequential therapy.

KEYWORDS: Sequential chemoimmunotherapy; Bladder cancer; BCG; MMC.

CORRESPONDENCE: Dr. Ahmed Mohamed Shelbaia, Borg El Atbaa, Faisal Street, Giza, Cairo, Egypt ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.06

ABBREVIATIONS AND ACRONYMS: BCG, bacillus Calmette-Guerin; MMC, mitomycin; TUR, transurethral resection.

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INTRODUCTION: Pelvic surgery can result in injuries to the parasympathetic innervation of the pelvic organs. Such injuries can involve both preganglionic and postganglionic lesions. The purpose of the present study was to describe activation of the pelvic ganglion cells by the transcription factors ATF3 and p-c-Jun after preganglionic or postganglionic lesions in the rat.

METHODS: ATF3, p-c-Jun, and ED1 were monitored in rat pelvic ganglia 4 days after preganglionic and postganglionic lesions using immunocytochemistry.

RESULTS: Control ganglia exhibited weak nuclear staining for p-c-Jun but not ATF3. Postganglionic lesions induced ATF3 and p-c-Jun in neuronal nuclei. In contrast, preganglionic lesions induced ATF3 and p-c-Jun mainly in the nuclei of satellite cells and Schwann cells, although some neuronal nuclei were intensely p-c-Jun positive. No neurons expressing ATF3 were found. Staining by ED1 showed an increased number of macrophages in the ganglia after preganglionic lesions.

CONCLUSION: The authors hypothesize that the induction of nuclear ATF3 and p-c-Jun in Schwann cells and satellite cells is induced by degeneration, and that the expression of p-c-Jun and ATF3 in neuronal nuclei reflects activation of sprouting mechanisms.

KEYWORDS: Pelvic ganglion; p-c-Jun; ATF3; Denervation; Decentralization

CORRESPONDENCE: Bengt Uvelius, MD, Department of Urology, Skane University Hospital, SE-20502 Malmo, Sweden ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.18

ABBREVIATIONS AND ACRONYMS: NO, nitric oxide; PBS, phosphate-buffered saline; TH, tyrosine hydroxylase; VIP, vasoactive intestinal peptide.

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INTRODUCTION: Alpha-1 adrenoceptor antagonists are the mainstay for treatment of symptomatic benign prostatic hyperplasia (BPH). Tamsulosin and alfuzosin, the most commonly prescribed drugs, have good efficacy and safety. However, there is paucity of data comparing the modified release (MR) or sustained release (SR) formulas. The purpose of the present study was to compare the efficacy and safety of tamsulosin-MR 0.4 mg with alfuzosin-SR 10 mg in patients with symptomatic BPH.

METHODS: A total of 90 patients participated in the single-blind, parallel-trial design. Patients were randomly assigned to equal groups, receiving tamsulosin-MR (0.4 mg) or alfuzosin-SR (10 mg). Both were taken once daily for 12 weeks. The International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax) were determined before and at 6 weeks and 12 weeks after the initiation of therapy. The number of adverse events was recorded.

RESULTS: Patients in both groups had a significant mean change in both IPSS and Qmax at the end of 6 weeks and 12 weeks of therapy (P < .001). There was no significant group difference in mean IPSS or Qmax at 6 weeks. At 12 weeks, the group receiving tamsulosin had a significantly lower IPSS (P = .048) and a significantly higher Qmax (P = .045) than the group receiving alfuzosin. Adverse events were infrequent and not statistically different between groups. Dizziness and impotence were most common with tamsulosin; dizziness and fatigue were most common with alfuzosin.

CONCLUSION: Tamsulosin-MR was significantly more effective than alfuzosin-SR in improving IPSS score and Qmax at the end of 12 weeks of treatment, although the group differences in outcome measures were small.

KEYWORDS: Tamsulosin; Alfuzosin; BPH; IPSS; Qmax.

CORRESPONDENCE: Amitabh Dash, MD, A-3, MIG Flats, Prasad Nagar, Phase II, New Delhi, 110005, India ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.19

ABBREVIATIONS AND ACRONYMS: BOO, bladder outlet obstruction; BPH, benign prostatic hyperplasia; IPSS, International Prostate Symptom Score; LUTS, lower urinary tract symptoms; MR, modified release; PVR, postvoid residual; Qmax, maximum urinary flow rate; SR, sustained release.

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