PURPOSE: The overactive bladder (OAB) syndrome is characterized by urgency usually with frequency and nocturia. Tamsulosin, alpha1-adrenergic receptor antagonist, is widely used to reduce symptoms of urinary obstruction and prostatic hyperplasia. Tamsulosin can across the blood-brain barrier. We investigated the effects of tamsulosin on the symptoms of OAB in relation to neuronal activity using rats. METHODS: Adult female Sprague-Dawley rats, weighing 250+/-10 g (9 weeks old), were used in this study. The animals were divided into five groups (n=8 in each group): control group, OAB-induced group, OAB-induced and 0.01 mg/kg tamsulosin-treated group, OAB-induced and 0.1 mg/kg tamsulosin-treated group, and OAB-induced and 1 mg/kg tamsulosin-treated group. OAB was induced by intraperitoneal injection of cyclophosphamide (75 mg/kg) every third day for 10 days. The rats in the tamsulosin-treated groups orally received tamsulosin once a day for 14 consecutive days at the respective dose of the groups, starting 1 day after the induction of OAB. Cystometry for bladder pressure determination, immunohistochemistry for c-Fos, nicotinamide adenine dinucleotide phosphate-diaphorase histochemistry for nitric oxide synthase (NOS) in the neuronal voiding centers and western blot for inducible NOS in the bladder were conducted. RESULTS: Cyclophosphamide injection enhanced contraction pressure and time, representing the induction of OAB. Contraction pressure and time were significantly suppressed by tamsulosin treatment. c-Fos and NOS expressions in the neuronal voiding centers were enhanced by induction of OAB. OAB-induced c-Fos and NOS expressions were suppressed by tamsulosin treatment. CONCLUSIONS: Tamsulosin exerts inhibitory effect on neuronal activation in the neuronal voiding centers of OAB. The present results suggest the possibility that tamsulosin is effective therapeutic modality for ameliorating the symptoms of OAB.
Adult ; Animals ; Blood-Brain Barrier ; Blotting, Western ; Contracts ; Cyclophosphamide ; Female ; Humans ; Immunohistochemistry ; Injections, Intraperitoneal ; NAD ; Neurons ; Nitric Oxide Synthase ; Nocturia ; Prostatic Hyperplasia ; Rats ; Rats, Sprague-Dawley ; Sulfonamides ; Urinary Bladder ; Urinary Bladder, Overactive

PURPOSE: We investigated the significance of bcl-2 and p53 protein expressions as the prognostic factor in metastatic prostate adenocarcinoma. MATERIALS AND METHODS: Nineteen paraffin-embedded prostatic cancer tissues were examined using immunohistochemical staining for bcl-2 and p53 protein. We evaluated correlation of bcl-2 and p53 protein expressions with cancer progression free interval, pretreatment PSA and Gleason score. RESULTS: Seven out of 19 cases (36.9%) were positive for p53 and 3 cases (15.8%) were positive for bcl-2 protein. Mean disease progression free interval in positive patients for bcl-2 and p53 protein expressions was 8.7 months and 10.3 months, respectively. However, it was 18.3 months and 21 months in negative expressions, respectively. The difference of mean disease progression free interval between positive and negative groups for p53 protein expression was statistically significant (p<0.05) but not in bcl-2 protein groups. The rates of positive staining for bcl-2 and p53 protein were 0% (0/8) and 37.5% (3/8), respectively, in Geason score 5-7 groups, 27.3% (3/11) and 36.4% (4/11) in 8-10 groups. Neither of proteins had significant correlation with Gleason score and pretreatment PSA. CONCLUSIONS: The expression of p53 protein was correlated with significant short disease progression free interval but bcl-2 overexpression had relative short disease progression interval without statistical significance. These results suggest that expressions of bcl-2 and p53 have considerable prognostic impact and these gene products would provide useful information about prognosis of metastatic prostate adenocarcinoma.
Adenocarcinoma* ; Disease Progression ; Humans ; Neoplasm Grading ; Neoplasm Metastasis ; Prognosis ; Prostate* ; Prostatic Neoplasms ; Staphylococcal Protein A*

PURPOSE: Tamsulosin 0.2 mg is used widely in Asian people, but the low dose has been studied less than tamsulosin 0.4 mg or other alpha blockers of standard dose. This study investigated the efficacy and safety of tamsulosin 0.2 mg by a meta-analysis and meta-regression. MATERIALS AND METHODS: We conducted a meta-analysis of efficacy of tamsulosin 0.2 mg using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). Safety was analyzed using adverse events. Relevant studies were searched using MEDLINE, EMBASE, and Cochrane library from January 1980 to June 2013. RESULTS: Ten studies were included with a total sample size of 1418 subjects [722 tamsulosin 0.2 mg group and 696 other alpha-blockers (terazosin, doxazosin, naftopidil, silodosin) group]. Study duration ranged from 4 to 24 weeks. The pooled overall standardized mean differences (SMD) in the mean change of IPSS from baseline for the tamsulosin group versus the control group was 0.02 [95% confidence interval (CI); -0.20, 0.25]. The pooled overall SMD in the mean change of QoL from baseline for the tamsulosin group versus the control group was 0.16 (95% CI; -0.16, 0.48). The regression analysis with the continuous variables (number of patients, study duration) revealed no significance in all outcomes as IPSS, QoL, and Qmax. CONCLUSION: This study clarifies that tamsulosin 0.2 mg has similar efficacy and fewer adverse events compared with other alpha-blockers as an initial treatment strategy for men with lower urinary tract symptoms.
Adrenergic alpha-1 Receptor Antagonists/*administration & dosage/therapeutic use ; Adrenergic alpha-Antagonists ; Dose-Response Relationship, Drug ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia/*complications ; *Quality of Life ; Sulfonamides/*administration & dosage/therapeutic use