Long-term results of medical treatment in benign prostatic hyperplasia

Urology. 2006 Nov;68(5):1015-9. doi: 10.1016/j.urology.2006.06.003. Epub 2006 Nov 7.

Abstract

Objectives: In real-life clinical practice, we determined the incidence of acute urinary retention (AUR) and benign prostatic hyperplasia (BPH)-related surgery in patients with BPH who received alpha-adrenergic receptor blocker (alpha-blocker) and/or 5-alpha-reductase inhibitor combination treatment.

Methods: This retrospective study enrolled 341 patients with BPH who were prescribed an alpha-blocker and/or a 5-alpha-reductase inhibitor as their first treatment from January 1997 to June 1999. Using follow-up data from a 6 to 8-year period, we calculated the incidence of AUR and BPH-related surgery in the alpha-blocker-only group and in the combination group.

Results: Of the 341 patients, 192 were in the alpha-blocker group and 149 were in the combination group. Of these, 17.7% in the alpha-blocker group and 12.1% in the combination group experienced AUR (P <0.05). BPH-related surgery was performed in 10.9% of the alpha-blocker-only group and 6.0% of the combination group (P <0.05). The incidence of AUR and BPH-related surgery was reduced by 32.3% and 48.9% when the prostate volume was larger than 35 g and by 49.4% and 60.6% when the prostate-specific antigen level was greater than 2.0 ng/mL, respectively, in the combination group compared with the corresponding values in the alpha-blocker group.

Conclusions: Real-life clinical practice showed that long-term combination treatment with alpha-blockers and 5-alpha-reductase inhibitors reduced the risk of BPH progression, such as AUR or BPH-related surgery, compared with alpha-blocker-only treatment.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adrenergic alpha-Antagonists / therapeutic use*
  • Aged
  • Cholestenone 5 alpha-Reductase / antagonists & inhibitors*
  • Drug Therapy, Combination
  • Humans
  • Incidence
  • Male
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / drug therapy*
  • Prostatic Hyperplasia / surgery
  • Retrospective Studies
  • Time Factors
  • Urinary Retention / epidemiology
  • Urinary Retention / etiology*
  • Urinary Retention / surgery

Substances

  • Adrenergic alpha-Antagonists
  • Cholestenone 5 alpha-Reductase