In an older man on tamsulosin for BPH who is presenting with recurrent falls, how do you manage the medication, in light of urinary symptom control and fall risk?

Tamsulosin carries the risk of orthostatic hypotension and falls, especially in older adults¹. In the situation of an older adult man taking tamsulosin for BPH symptoms who is presenting with recurrent falls, I would first check orthostatic vitals and if positive, I would discuss this finding with t...

Tamsulosin increases the risk of orthostatic hypotension and falls. While untreated lower urinary tract symptoms, including urgency, frequency, incontinence, and nocturia, are also associated with a high risk of falls. In some cases, BPH leads to AKI and functional incontinence with poor quality of ...

When managing LUTS (lower urinary tract symptoms), the standard of care is to treat empirically, based on a presumptive diagnosis of obstruction (then offer behavioral management followed by alpha blockers, 5 alpha reductase inhibitors, or phosphodiesterase type 5 inhibitors) or overactive bladder (...

A physical examination including orthostatics, DRE, and an ultrasound of the residual or pelvic US, as well as a urinalysis and/or culture if necessary, would be fundamental in the evaluation and then treatment of a patient in this situation. Prostate volume may predict outcome of treatment with fiv...