Tamsulosin Therapy for Benign Prostatic Hyperplasia

Patient Selection and Treatment

• The European Association of Urology recommends considering tamsulosin in patients with benign prostatic hyperplasia (BPH) and acute urinary retention, as it facilitates successful voiding after catheter removal 1
• The ideal patient for tamsulosin is a man over 50 years old with moderate to severe lower urinary tract symptoms that interfere with his quality of life, particularly voiding symptoms (hesitation, weak stream, incomplete emptying, intermittency) 1

Combination Therapy

• The combination of tamsulosin with anticholinergics (solifenacin) or beta-3 agonists (mirabegron) is supported for men with mixed voiding and storage symptoms (urgency, frequency) 2, 3

Safety Considerations

• The American Urological Association and the European Association of Urology recommend that all patients planning cataract or glaucoma surgery should inform their ophthalmologist about the use of tamsulosin, as it is associated with intraoperative floppy iris syndrome that complicates the procedure 1, 4

Contraindications

• The European Association of Urology states that tamsulosin is contraindicated in patients without a prostate (post-prostatectomy), as the therapeutic target—prostatic smooth muscle causing obstruction—is absent 5
• The American Urological Association and the European Association of Urology also state that tamsulosin should not be used in patients without evidence of prostatic enlargement, as it is not appropriate for lower urinary tract symptoms of other etiologies 5