Elucidation of the Pattern of the Onset of Male Lower Urinary Tract Symptoms Using Cluster Analysis: Efficacy of Tamsulosin in Each Symptom Group

作者：Aikawa Ken^*; Kataoka Masao; Ogawa Soichiro; Akaihata Hidenori; Sato Yuichi; Yabe Michihiro; Hata Junya; Koguchi Tomoyuki; Kojima Yoshiyuki; Shiragasawa Chihaya; Kobayashi Toshimitsu; Yamaguchi Osamu

来源：Urology, 2015, 86(2): 349-353.

DOI：10.1016/j.urology.2015.04.036

OBJECTIVE To present a new grouping of male patients with lower urinary tract symptoms (LUTS) based on symptom patterns and clarify whether the therapeutic effect of alpha 1-blocker differs among the groups.
METHODS We performed secondary analysis of anonymous data from 4815 patients enrolled in a postmarketing surveillance study of tamsulosin in Japan. Data on 7 International Prostate Symptom Score (IPSS) items at the initial visit were used in the cluster analysis. IPSS and quality of life (QOL) scores before and after tamsulosin treatment for 12 weeks were assessed in each cluster. Partial correlation coefficients were also obtained for IPSS and QOL scores based on changes before and after treatment.
RESULTS Five symptom groups were identified by cluster analysis of IPSS. On their symptom profile, each cluster was labeled as minimal type (cluster 1), multiple severe type (cluster 2), weak stream type (cluster 3), storage type (cluster 4), and voiding type (cluster 5). Prevalence and the mean symptom score were significantly improved in almost all symptoms in all clusters by tamsulosin treatment. Nocturia and weak stream had the strongest effect on QOL in clusters 1, 2, and 4 and clusters 3 and 5, respectively.
CONCLUSION The study clarified that 5 characteristic symptom patterns exist by cluster analysis of IPSS in male patients with LUTS. Tamsulosin improved various symptoms and QOL in each symptom group. The study reports many male patients with LUTS being satisfied with monotherapy using tamsulosin and suggests the usefulness of alpha 1-blockers as a drug of first choice.

• 出版日期2015-8