Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 9142-9147
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.9142
Tamsulosin-induced life-threatening hypotension in a patient with spinal cord injury: A case report
Jae Young Lee, Ho Seok Lee, Si-Bog Park, Kyu Hoon Lee
Jae Young Lee, Ho Seok Lee, Si-Bog Park, Kyu Hoon Lee, Rehabilitation Medicine, Hanyang University Hospital, Seoul 04763, South Korea
Author contributions: Lee JY was the patient’s physiatrist, reviewed the literature, and contributed to manuscript drafting; Lee HS was the patient’s physiatrist and reviewed the literature; Park SB reviewed the literature and contributed to manuscript drafting; Lee KH was responsible for manuscript revision for important intellectual content; all authors issued final approval for the version to be submitted; The authors alone are responsible for the content and writing of the article.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), according to which the manuscript was prepared and revised.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kyu Hoon Lee, MD, PhD, Professor, Rehabilitation Medicine, Hanyang University Hospital, No. 222-1 Wangsimni-ro, Seongdong-Gu, Seoul 04763, South Korea. dumitru1@hanyang.ac.kr
Received: April 19, 2022
Peer-review started: April 19, 2022
First decision: May 30, 2022
Revised: June 8, 2022
Accepted: July 22, 2022
Article in press: July 22, 2022
Published online: September 6, 2022
Abstract
BACKGROUND

Tamsulosin, a selective α1-adrenergic receptor antagonist, is commonly used for treating neurogenic bladder in patients with spinal cord injury (SCI). No severe adverse events have been described with such tamsulosin use. To our knowledge, we report the first case of severe life-threatening hypotension as an adverse effect of tamsulosin in a person with SCI. Therefore, we report this case to inform that this severe adverse effect of tamsulosin can occur when treating patients with SCI.

CASE SUMMARY

A 59-year-old woman was diagnosed with cervical spinal cord myelopathy and was classified as American Spinal Injury Association Impairment Scale D, neurological level of injury C3. Because she suffered from voiding difficulty due to neurogenic bladder, we prescribed tamsulosin. Her vital signs remained stable, but occasional hypotensive symptoms followed defecation. We reduced the dose of tamsulosin, but after administering tamsulosin for 9 d, she experienced life-threatening hypotension with no evidence of hypovolemic shock, neurogenic shock, cardiogenic shock, or septic shock. A hypotensive condition induced by tamsulosin was the suspected cause, and her symptoms could be associated with adverse effects of tamsulosin. As symptoms resolved after stopping tamsulosin, and no other reason was found, we concluded that tamsulosin was the cause of her symptoms.

CONCLUSION

Caution for severe hypotension is needed when administering tamsulosin for neurogenic bladder in a patient with SCI.

Keywords: Tamsulosin, Neurogenic bladder, Spinal cord injury, Hypotension, Vasovagal symptoms, Case report

Core Tip: Voiding difficulty is a common symptom of spinal cord injury (SCI) due to neurogenic bladder. Tamsulosin is commonly used for treating neurogenic bladder. However, this case demonstrated that tamsulosin can cause severe life-threatening hypotension. Thus, clinicians should be aware of this possible condition when treating neurogenic bladder in a patient with SCI.