Tamsulosin vs. transurethral resection: which is more effective in treating nocturia due to BPH?

This study compared the effects of tamsulosin (Flomax) treatment to transurethral resection of the prostate (TURP) to treat nocturia in men with benign prostatic hyperplasia (BPH). The study determined that TURP was more effective than tamsulosin at treating nocturia in men with BPH. 
 

Benign prostatic hyperplasia (BPH) can be associated with lower urinary tract symptoms (LUTS). LUTS can include nocturia, or an increased urge to urinate at night. This can cause a patient to wake frequently and reduces the number of hours of sleep and sleep quality. 

Men with BPH may undergo a procedure called transurethral resection of the prostate (TURP). This involves removing tissue from an enlarged prostate and can improve urine flow. This can help treat nocturia due to BPH. Another treatment is tamsulosin. Tamsulosin is a drug that blocks alpha-adrenoreceptors, causing the bladder muscle to relax. This reduces the urge to urinate. 

It is not clear if tamsulosin or TURP is more effective in treating nocturia.

This study compared the effects of tamsulosin or TURP on nocturia in men with BPH.

The study included 66 men with BPH who had had no previous treatment for urinary symptoms. Patients were randomly assigned to receive 0.4 mg tamsulosin once daily or to undergo TURP. Patients were assessed at the start of the study, at 3 months and after 1 year. The number of nighttime awakenings and hours of undisturbed sleep were recorded. 

Both tamsulosin and TURP improved nocturia symptoms. At 3 months and 1 year, the number of awakenings at night and HUS were reduced in both groups compared to baseline. Symptoms and quality of life improved in both groups, as did hours of sleep. However, TURP patients had a greater improvement in nocturia symptoms compared to tamsulosin patients at 3 and 12 months.
 

The authors concluded that TURP was more effective than tamsulosin at relieving nocturia in men with BPH.

This was a relatively small study – more patients should be included in a follow-up study to confirm these findings. The number of sleep hours was slightly higher at baseline in the TURP group.