Presentation by Jake Seaney, Austin Whiting, Owen Arave, Eric Gallardo
So our project was on a paper called tamsilos and versus prison on women with voiding dysfunction um so you might think it’s a little weird that we are doing our project on a study about women but there is a back story so um i have had an experience with tim solos and that and that was our motive for looking into this and choosing this paper so initially we
Had chosen a paper that didn’t really meet the requirements that we needed for this project but as we were looking more into it i had this bottle of pills laying around and we decided to look into that medication and try and find some research on it so so we ended up looking and we found this this article so um i had taken tamsilos in previously um for kidney
Stones and the reason being is normally they just give you pain medication like opioids but i really don’t do well with opioids so i was getting really nauseous headaches um i was getting really like upset for no reason and so i’ve had i’ve had those issues so this time when i when it happened um and i was sorry to pass kidney stone i told the doctor and he’s
Like well i can give you this drug it’s just a muscle relaxer don’t even worry about it take it and you’ll be fine so that’s what i did and then um so when we when we got back around to this project we were looking into the other uses for tamsulosa and its actual use we found this study which we thought was really cool so it treats boo which is called bladder
Outlet obstruction it’s also called voiding dysfunction and boo can be it can be described as an increase in pressure in the detrucer muscle which is a layer of smooth muscle that surrounds your bladder and then also decrease flow rate of urine and so it’s normally diagnosed by studying these two parameters both the pressure of the bladder and then also flow of
Of urine and something we thought was super interesting is is the women aspect of this study so obviously as a man when i took this drug i knew it worked for me but i didn’t realize that it wasn’t a universal drug so what makes this study is uh important and interesting to us is the fact that these medications aren’t even fda approved for boo related symptoms
In women and part of that reason being is the mechanism by which um these things happen between men and women are different so for men normally voiding dysfunction problems are caused by an enlarged prostate which is smooth muscle whereas for women it’s normally caused by increased tightness in their pelvic floor which is skeletal muscle and so because of that
Difference it hasn’t really been studied much in women so for women with boo they may develop increased bladder retention which causes an increase in urinary tract infections also kidney failure and then overall decreased quality of life it can be you know more frequent urination painful urination on those kinds of of issues so some factors in women that can
Contribute to these symptoms are age um how many children that they’ve given birth to menopause certain diseases like diabetes also the medications they’re taking any surgery that they’ve had to their pelvic floor and then also any neurological damage can cause these symptoms in women so the objective of the study was to use to study the effects of tamsulosin
And then also prazos and which is a similar drug on the clinical and urodynamic parameters with voiding dysfunction awesome so like jake said the goal was to compare the difference of tamsulosin and prosocian and the impacts that it has on women with bladder outlet obstruction and so just before we dive into the results and the way the study was set up i think
It’s really important to understand um just a quick recap on on the right hand side you’ll see a picture of the bladder and on the upper side of the bladder you’ll see a beta receptor and then at the bottom there on the neck of the bladder you’ll see an alpha receptor so these are sympathetic nervous system receptors and so here a few years ago i was out on a
Hike in the tetons i was with my dad and a bunch of his co-workers and we were we were going on this 16 mile hike and so we had just barely started and we passed by this bathroom on the right-hand side on our way and i needed to go to the bathroom but i was so excited to be out on a hike it had been a while that i was like oh i’ll be fine i just i just didn’t
Even think about it but as kind of the time went on as the miles passed by i was starting to question my choice and i was like man i i really should have stopped at that bathroom so you know mile two and a half mile three i’m thinking to myself wow i really should have stopped and it started to get kind of bad and right when it was getting bad i came around the
Corner and i was up in front of everybody kind of front of the pack and this huge bear was just walking down the path right in front of me and it was close enough i could see the hair swinging back and forth i could see the shoulder blades coming up and down with every step and i know that brother hunt and probably the rest of the class is hoping that i would
Say that i i wet my pants uh and for the sake of the story i wish that i could say that as well but that was not the case what happened for me is i just had a huge adrenaline rush there was a lot of alpha stimulation and almost instantly almost instantly the last thing on my mind was going to the to the bathroom i was reaching for my bear spray i was making noise
I was letting the people around me know and so that’s kind of what happens with the alpha stimulation is it can make it difficult to go to the bathroom and so the goal with tamsulosin and also person is their alpha antagonists so they mitigate the effects of alpha stimulation by preventing it and so the study was conducted in iran the reason for that is between
13 to 20 percent of women in iran will struggle with buu at one point in their lifetime and so the way that it was set up is there were 53 women who had the symptoms who came in uh mainly it was frequency and nocturia how often they were going to the bathroom both during the daytime and also how frequently they were woke up at night with the urge to go so they
Were between the ages of 20 and 65 and so from that sample size of 53 there were a few criteria that had to be met one was if you had low brush low blood pressure or hypotension then you could not participate in the study reason for that being if you already have low blood pressure it’s not ideal to take an alpha antagonist because that can lower the blood
Pressure even more so that was one requirement the second requirement was you could not have had a spinal cord injury that is more of a neurological dysfunction and that was not the purpose of this study and then finally the patient or the the people who wanted to go through the test they could not have had pelvic floor surgery either and so just a a couple
Things to to mention uh with the tamsulosin and the prosocial there are different sample sizes or serving sizes excuse me a reason for that being the tensorloss and you could only take point four because it would lower the heart rate more dramatically than prozocine would and so you definitely have to keep a close eye on that the with the prosocian you took one
To two milligrams every day so i mean the the dosages were pretty different and then the the results with temp solution were typically felt within 48 hours with the prosocian being felt within three hours but the patients were on the drugs for three months each and so after all was said and done there were only 40 patients who could participate in the study so
20 patients took the prosociant in 20 took the tempsulosin it was a double-blind study so they were not sure of which medication they were taking and they would meet with the doctor once every month during the study and they rank their satisfaction based off of very satisfied relatively satisfied and not satisfied at all and so when all was said and done there
Were two patients who ignored the prosocian and there was one that ignored the tensor loss and so our sample sizes were 18 and 19. and so in order to compare the results from both of those medications temp sulocin and prosocin urodynamic tests were done on the test subjects to see the effectiveness and the aerodynamic tests actually give more information about
The urination cycle and how your bladder muscles are work and so with the red arrow indicating or shown on this slide the red arrow indicates what urodynamic tests were done and so starting from the top going down we have pvr which is the post void residual volume which is the amount of urine left in the bladder after urinating there’s the average flow rate q
Max which is the maximal flow rate and the urethral closure pressure which is the pressure along the the length of the urethra with the bladder at rest and the last test that was done was the pressure at q max and this table taken directly from the study shows the for treatment and after treatment of both the medications of tams melisin and prison so to better
Visualize the before and after treatments we used the the data from the table before the previous table and applied it into this graph so in blue shows before treatment and red indicates after treatment and on the x-axis is the the aerodynamic tests that were done and so with with this graph you’ll be able to notice that there was a decrease in the post-void
Residual volume and the urethral closure pressure and something interesting to note is that the the average flow rate did not change or did not normalize with the use of tamsillusin and with the results of prosocian the same interesting fact was shown with this medication as well as that the average flow rate did not normalize it did not increase or decrease
But it did show a decrease in the post void residual volume the same as tens ten solution and then also the urethral closure pressure and this this figure taken directly from the research article as well shows the percent of normalization of each of the urodynamic tests or the the normalization of the parameters of each test and so the red arrows will indicate
The decrease of normalization and the green arrows indicate which test actually increased in the normalization of the aerodynamic parameters so the question to be posed the conclusion of this study is is why does it matter and what can we learn from this and this study was able to give us a lot of valuable insight into these alpha blockage medications and the
Effect that they can have for bladder outlet obstruction on women and so as discussed those two medications that were compared were tamsulosin and person and and from those graphs uh we were able to see that the urodynamic parameters were able to change in a favorable manner towards normality but they weren’t able to change enough uh to the normal parameters
That we’d like to see as discussed and so um our thoughts or from this study i mean we’re all obviously able to see that the um the medications were able to you know help because they were alpha blockage um but you know what what we thought could be further done uh to to be beneficial in this um you know area of medicine is to study a medication called alphazosin
And so what this is uh it’s it’s the more popular medication um for bladder outlet obstruction for men um with very few side effects uh and so this is an alpha one blocker um as well as the the tamsulosin was an alpha one blocker and so what we think is is you know if this medication uh were to be further you know researched in the um in regards to women uh that
Their you know their side effects of bladder outlet obstruction uh will be able to be mitigated uh quite more than the tam slow sin was and really just you know help them and their over quality of life
Transcribed from video
Tamsulosin vs. Prazosin on Women with Voiding Dysfunction By Jake Seaney
