Effect of naftopidil on nocturia after failure of tamsulosin

The clinical usefulness of naftopidil was evaluated in 122 patients with benign prostatic hyperplasia for urinary tract symptoms and signs, focused in particular on nocturia.

A total of 122 patients with BPH whose symptoms did not improve after 6 weeks of tamsulosin administration were enrolled. After the treatment was followed by a washout period with placebo, patients were prescribed 75 mg of naftopidil to be taken after dinner for 6 weeks, and the efficacy was re-evaluated. All the drugs used were unidentified, and attention was given to not have the patients recognize the change in the drug given. The primary purpose of this study was the improvement of nocturia in patients with a poor response to tamsulosin. The clinical efficacy of naftopidil was defined as significant improvement in International Prostate Symptom Score, quality-of-life index, and maximal urinary flow rate.

After 6 weeks of naftopidil administration, significant improvements in daytime and nighttime frequency, International Prostate Symptom Score, quality-of-life index, maximal flow rate, average flow rate, and bladder compliance were examined. On the International Prostate Symptom Score questionnaire, improvement in the sensation of the bladder not emptying and a reduction in nighttime frequency stood out. Moreover, detrusor overactivity was observed in 40 patients before the start of treatment and was eliminated in 31. The effective rate of this study was 69.7% (85/122).

Naftopidil has novel effects in patients with BPH whose main complaints are storage and voiding symptoms, especially that of nocturia of >or=3 times, as well as in patients with a low compliance bladder and detrusor overactivity, who did not respond to tamsulosin.