Objectives: To evaluate the association of prostate biopsy with voiding impairment and to investigate whether tamsulosin treatment given before prostate biopsy could improve voiding dysfunction after the procedure.
Methods: The study included 88 consecutive patients who underwent transrectal ultrasound-guided prostate biopsy without prior BPH medication and were prospectively randomized. Of these 88 patients, 44 patients underwent prostate biopsy only without tamsulosin treatment and served as the control group. The remaining 44 patients were treated with tamsulosin (0.2 mg daily) beginning the day before the biopsy procedure for 7 days. The International Prostate Symptom Score (IPSS) was recorded in all patients before the procedure and on postbiopsy day 7. Maximal flow rate (Q(max)) and postvoid residual urine volume were recorded in all patients before the procedure and on postbiopsy days 1 and 7.
Results: No difference was found in baseline characteristics between the two groups. The IPSS (total, storage, and voiding symptom) was not significantly changed after biopsy in both groups. In the control group, the postvoid residual urine volume was increased on postbiopsy days 1 (P < 0.05) and 7, and the Q(max) was significantly decreased on postbiopsy day 7 compared with the baseline value (P < 0.05). In the tamsulosin group, Q(max) was significantly increased on postbiopsy days 1 and 7 (P < 0.01). The postvoid residual urine volume was not increased on postbiopsy days 1 and 7. Acute urinary retention after the biopsy procedure did not develop in any of the patients (0%) in the tamsulosin group, but it developed in two patients (4.5%) of the control group.
Conclusions: The results of our study show that prostate biopsy leads to objective voiding impairment. Therefore, the use of alpha-1 blocker tamsulosin before biopsy in patients without prior BPH medication may decrease this morbidity.