From the Guidelines
Tamsulosin (Flowmax) is not recommended for urinary retention in females due to its mechanism of action being primarily targeted at benign prostatic hyperplasia (BPH) in men. The medication's efficacy in men with BPH is well-documented, with studies such as 1 showing improvement in acute urinary retention (AUR) signs and symptoms. However, women do not have a prostate gland, making the medication's mechanism less relevant. For female urinary retention, the approach should focus on addressing the underlying cause, which may include:
- Pelvic floor physical therapy
- Intermittent catheterization
- Other medications depending on the specific etiology The typical dose of tamsulosin for men is 0.4 mg once daily, taken 30 minutes after the same meal each day, but evidence supporting its use in women is limited 1. Before considering any treatment, women with urinary retention should undergo proper diagnostic evaluation to identify specific causes such as:
- Neurological conditions
- Medication side effects
- Anatomical issues as these would require targeted treatments rather than alpha-blockers like tamsulosin. The lack of standardized follow-up in studies, such as 1, also makes it unclear whether alpha blocker therapy is effective in treating AUR in the long term. Given the limited evidence and potential for underlying causes that require alternative treatments, tamsulosin should not be prescribed as a first-line treatment for urinary retention in females.
From the Research
Efficacy of Tamsulosin for Urinary Retention in Females
- The efficacy of Tamsulosin (Flowmax) for urinary retention in females is supported by a study published in 2005, which found that 56% of women with functional bladder neck obstruction showed significant improvement in symptoms, maximum flow, and postvoid residual urine volume after treatment with Tamsulosin 2.
- This study suggests that Tamsulosin may be an effective treatment option for female functional bladder neck obstruction, a condition that can cause urinary retention.
- However, it is essential to note that the majority of the studies provided focus on the treatment of urinary retention in males, particularly those with benign prostatic hyperplasia (BPH) 3, 4, 5, 6.
- There is limited evidence specifically addressing the efficacy of Tamsulosin for urinary retention in females, and more research is needed to fully understand its effects in this population.
Comparison with Other Treatments
- A study published in 1991 found that clean intermittent catheterization with or without pharmacological treatment achieved a success rate of over 85% in treating urinary retention in females 3.
- Another study published in 2012 suggested that intermittent catheterization is often the most effective option for treating chronic urinary retention in women 4.
- In contrast, the study on Tamsulosin found that 56% of women with functional bladder neck obstruction showed significant improvement after treatment 2.