Impact of metabolic syndrome on combination therapy efficacy in LUTS due to BPH: a prospective study.

OBJECTIVES

Benign prostatic hyperplasia (BPH) is a common benign tumor in men, with an age-related prevalence of multifactorial etiology. The present study aimed to accurately assess and predict the effect of co-existing metabolic syndrome (MtS) upon treatment outcomes of combination medical therapy in select patients of lower urinary tract symptoms (LUTS) due to BPH.

METHODS

After obtaining informed consent from the patients, 70 eligible patients with LUTS due to BPH with and without MtS were enrolled in this study from September 2022 to January 2024 from the outpatient clinic at the University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi and were treated with a combination of Tamsulosin and Dutasteride, for two months, as per the protocol. The outcomes measured were a change in the International Prostate Symptom Score (IPSS), mean flow rate (MFR), and peak urine flow (Qmax) rates. Data was analysed using SPSS version 23.

RESULTS

The reduction in IPSS was higher in the control group than in the case group (p < 0.001), and the difference in MFR between the groups was also statistically significant (p < 0.001). Although there was a significant change in Qmax in both groups, the difference in the improvement in Qmax between the two groups was not significant (p < 0.829). The control group appeared to have achieved better symptomatic relief after treatment than did the case group.

CONCLUSION

Metabolic syndrome had a negative adverse impact on medical treatment outcomes in selected patients of LUTS due to BPH. The study suggests that urologists should actively consider and appropriately counsel patients with LUTS-BPH and co-existing metabolic syndrome before selecting such patients for combination medical therapy.