A Randomized Clinical Trial Comparing Tamsulosin Versus Terazosin for Functional Bladder Outlet Obstruction in Women Publisher



Kazemi R ; Mamashlou A ; Kamali M ; Saberi N
Source: Translational Research in Urology Published:2025

Abstract

Introduction Voiding dysfunction is a prevalent health issue in women. Treatment options for women are limited, with alpha-blockers being the first-line therapy for obstructive lower urinary tract symptoms (LUTS). The aim of this research was to compare the efficacy and safety of Tamsulosin and Terazosin in the treatment of obstructive symptoms in females with functional bladder outlet obstruction. Methods The study included women aged 18-65 with at least 3 months of obstructive lower urinary tract symptoms, high post void residual (PVR), obstructive appearance in uroflowmetry study and high-pressure, low-flow appearance in urodynamic study. The patients were randomly divided into two groups: one group received a 0.4 mg tamsulosin capsule at night, and the other received 1 mg of terazosin daily for the first week and then 2 mg daily. The patients were evaluated for clinical symptoms and urodynamic parameters after three months. The primary outcome was the change in IPSS score at 12 weeks and secondary outcomes included PVR, Qmax, Qavg, MUCP and pdetQmax as well as safety and tolerability. Results After 12 weeks of treatment, both groups experienced significant reductions in International Prostate Symptom Score (IPSS) (4.32±0.61 and 4.72±0.74 points, P-value<0.001 for each), with no meaningful difference between them (Δ=0.40, P-value=0.214). Post-void residual volume fell slightly more with tamsulosin,with no significant between-group difference (P-value=0.36). Terazosin produced a slightly greater increase in average flow and Qmax compared with Tamsulosin; however, these between-group differences did not reach statistical significance (P-value=0.73). Maximum urethral closure pressure (MUCP) and detrusor pressure at Qmax (PdetQmax) decreased markedly with both treatments (P-value<0.001 for both), with no significant between-group difference. Conclusions Over 12 weeks, both tamsulosin and terazosin yielded small-to-moderate improvements in IPSS and urodynamic parameters in women with functional BOO without a clear difference in efficacy. Agent selection may therefore be guided by patient tolerance, comorbidities, and individual preference. Copyright © 2025 Urology Research Center (URC), Tehran University of Medical Sciences.