Ong Hueih Ling, Liao Chun-Hou, Kuo Hann-Chorng
Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
Division of Urology, Department of Urology, Cardinal Tien Hospital and School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
Int Neurourol J. 2016 Dec;20(4):356-362. doi: 10.5213/inj.1632526.263. Epub 2016 Dec 26.
To investigate long-term therapeutic effects and patient adherence to a combination therapy of a 5α-reductase inhibitor and an α-blocker and to identify causes of withdrawal from medication in patients with clinical benign prostatic hyperplasia (BPH).
BPH patients with lower urinary tract symptoms (LUTS) receiving combination therapy with follow-ups for 1-12 years were retrospectively analyzed. Therapeutic effects were assessed at baseline and annually by measuring International Prostatic Symptoms Score, quality of life index, total prostate volume (TPV), maximal flow rate, voided volume, postvoid residual volume and prostate-specific antigen level. Causes of discontinued combination therapy were also investigated.
A total of 625 patients, aged 40-97 years (mean, 73 years) were retrospectively analyzed. All measured parameters showed significant improvements after combination therapy. Three hundred sixty-nine patients (59%) discontinued combination therapy with a mean treatment duration of 2.2 years. The most common reasons for discontinued treatment were changing medication to monotherapy with α-blockers or antimuscarinics (124 patients, 19.8%), receiving surgical intervention (39 patients, 6.2%), and LUTS improvement (53 patients, 8.5%). Only 64 patients (10.2%) were loss to follow-up and 6 (1.0%) discontinued combined treatment due to adverse effects. Smaller TPV after short-term combination treatment caused withdrawal from combination therapy.
BPH patients receiving long-term combination therapy showed significant improvement in all measured parameters. Changing medication, improved LUTS and choosing surgery are common reasons for discontinuing combination herapy. A smaller TPV after short-term combination treatment was among the factors that caused withdrawal from combination therapy.
探讨5α-还原酶抑制剂与α-受体阻滞剂联合治疗临床良性前列腺增生（BPH）患者的长期治疗效果及患者依从性，并确定患者停药的原因。
回顾性分析接受联合治疗并随访1至12年的BPH伴下尿路症状（LUTS）患者。在基线时及每年通过测量国际前列腺症状评分、生活质量指数、前列腺总体积（TPV）、最大尿流率、排尿量、残余尿量和前列腺特异性抗原水平来评估治疗效果。还对联合治疗中断的原因进行了调查。
共回顾性分析了625例年龄在40至97岁（平均73岁）的患者。联合治疗后所有测量参数均有显著改善。369例患者（59%）中断联合治疗，平均治疗时间为2.2年。停药最常见的原因是改用α-受体阻滞剂或抗毒蕈碱药物单药治疗（124例患者，19.8%）、接受手术干预（39例患者，6.2%）和LUTS改善（53例患者，8.5%）。仅64例患者（10.2%）失访，6例（1.0%）因不良反应中断联合治疗。短期联合治疗后TPV较小导致退出联合治疗。
接受长期联合治疗的BPH患者所有测量参数均有显著改善。换药、LUTS改善和选择手术是中断联合治疗的常见原因。短期联合治疗后TPV较小是导致退出联合治疗的因素之一。
