Park Yong Hyun, Kim Tae Hyo, Lee Seung Wook, Chung Byung Ha, Cho Jin Seon, Lee Ji Youl
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Department of Urology, College of Medicine, Dong-A University, Busan, Korea.
Low Urin Tract Symptoms. 2017 May;9(2):75-81. doi: 10.1111/luts.12112. Epub 2015 Oct 9.
We aimed to examine the treatment patterns, and patient-reported outcomes (PROs) in benign prostatic hyperplasia (BPH) patients with overactive bladder (OAB) symptoms.
Seven hundred and forty seven patients were included in this prospective observational study. The primary endpoint was to describe the medical treatment patterns for BPH patients with OAB symptoms. The secondary endpoint was to determine the PROs of these patients. Clinical outcome was assessed using International prostate symptom score (IPSS), and PROs were measured using BPH-Related QoL Questionnaire Korea 1 (BPH QoL K1) and Euroqol-5 Dimension (EQ-5D).
When starting the study, 391 patients (52.3%) received α-blocker monotherapy, whereas 356 (47.7%) received combination therapy with anticholinergics. Of the 369 patients who completed the 6-month treatment, 139 patients (37.7%) still received α-blocker monotherapy, 122 (33.1%) still received combination therapy with anticholinergics, and 108 (29.3%) received subsequent anticholinergics in addition to α-blocker. When the patients were stratified, storage subscore was higher (9.5 vs. 8.8, P = 0.034) and voiding subscore (9.7 vs. 11.6, P = 0.001) was lower in patients with anticholinergics than those without it. Although all treatment groups reported a significant improvement from baseline, no significant between-group differences in changes in IPSS, EQ-5D and BPH QoL K1 was found.
About one-third of patients received α-blocker monotherapy, one-third received combination therapy with anticholinergics, and another one-third received subsequent anticholinergics in addition to α-blocker. Storage subscore was higher in patients with anticholinergics than those without it, but vice-versa for voiding subscore. Similar improvement on clinical outcomes and PROs was observed in all treatment groups.
我们旨在研究伴有膀胱过度活动症（OAB）症状的良性前列腺增生（BPH）患者的治疗模式及患者报告结局（PROs）。
本前瞻性观察性研究纳入了747例患者。主要终点是描述伴有OAB症状的BPH患者的药物治疗模式。次要终点是确定这些患者的PROs。使用国际前列腺症状评分（IPSS）评估临床结局，使用韩国前列腺增生相关生活质量问卷1（BPH QoL K1）和欧洲五维健康量表（EQ-5D）测量PROs。
研究开始时，391例患者（52.3%）接受α受体阻滞剂单药治疗，而356例（47.7%）接受抗胆碱能药物联合治疗。在完成6个月治疗的369例患者中，139例（37.7%）仍接受α受体阻滞剂单药治疗，122例（33.1%）仍接受抗胆碱能药物联合治疗，108例（29.3%）在接受α受体阻滞剂治疗的基础上随后加用了抗胆碱能药物。当对患者进行分层时，使用抗胆碱能药物的患者储尿子评分较高（9.5对8.8，P = 0.034），排尿子评分较低（9.7对11.6，P = 0.001）。尽管所有治疗组均报告与基线相比有显著改善，但在IPSS、EQ-5D和BPH QoL K1的变化方面未发现组间有显著差异。
约三分之一的患者接受α受体阻滞剂单药治疗，三分之一接受抗胆碱能药物联合治疗，另外三分之一在接受α受体阻滞剂治疗的基础上随后加用抗胆碱能药物。使用抗胆碱能药物的患者储尿子评分高于未使用的患者，但排尿子评分情况则相反。所有治疗组在临床结局和PROs方面均观察到类似的改善。
