Long-term results of medical treatment in benign prostatic hyperplasia.

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.