The efficacy of tamsulosin 0.4 mg when tamsulosin 0.2 mg is insufficient for benign prostatic hyperplasia in Korean patients

Abstract

Purpose: This study evaluated the clinical impact of escalating tamsulosin dosage from 0.2 to 0.4 mg in men with benign prostatic hyperplasia (BPH) who exhibited inadequate responses to the lower dose.

Materials and methods: A retrospective review was performed on 57 patients treated at Seoul National University Bundang Hospital in 2022. Uroflowmetry parameters, International Prostate Symptom Score (IPSS), and postvoid residual volume (PVR) were compared before and after dose escalation. Subgroup analysis was conducted by age, prostate volume, and concomitant 5-alpha-reductase inhibitor use.

Results: The mean maximum urinary flow rate value improved significantly from 14.4 to 17.7 mL/s (p<0.001), with consistent benefits across subgroups. No significant changes were observed in IPSS or PVR overall, although PVR decreases were significant in prostates >50 mL.

Conclusions: Escalating tamsulosin from 0.2 to 0.4 mg can meaningfully improve urinary flow in certain BPH patients, particularly those with larger prostates or concomitant 5-alpha-reductase inhibitor therapy.

Keywords: Benign prostatic hyperplasia; Lower urinary tract symptoms; Tamsulosin.

Chung Y, Jeong SJ, Song SH, Hong SK. The efficacy of tamsulosin 0.4 mg when tamsulosin 0.2 mg is insufficient for benign prostatic hyperplasia in Korean patients. Investig Clin Urol. 2026 Mar;67(2):186-191. doi: 10.4111/icu.20250569. PMID: 41775449; PMCID: PMC12956770.