alpha-Blocker Monotherapy and alpha-Blocker Plus 5-Alpha-Reductase Inhibitor Combination Treatment in Benign Prostatic Hyperplasia; 10 Years' Long-Term Results.
10.4111/kju.2012.53.4.248
- Author:
Teak Jun SHIN
1
;
Chun Il KIM
;
Choal Hee PARK
;
Byung Hoon KIM
;
Young Kee KWON
Author Information
1. Department of Urology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. cikim@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Adrenergic alpha-1 receptor antagonists;
5-alpha reductase inhibitors;
Prostatic hyperplasia
- MeSH:
5-alpha Reductase Inhibitors;
Adrenergic alpha-1 Receptor Antagonists;
Follow-Up Studies;
Humans;
Incidence;
Prostate;
Prostate-Specific Antigen;
Prostatic Hyperplasia;
Urinary Retention
- From:Korean Journal of Urology
2012;53(4):248-252
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We compared the effects of alpha-adrenergic receptor blocker (alpha-blocker) monotherapy with those of combination therapy with alpha-blocker and 5-alpha-reductase inhibitor (5-ARI) on benign prostatic hyperplasia (BPH) progression for over 10 years. MATERIALS AND METHODS: A total of 620 patients with BPH who received alpha-blocker monotherapy (alpha-blocker group, n=368) or combination therapy (combination group, n=252) as their initial treatment were enrolled from January 1989 to June 2000. The incidences of acute urinary retention (AUR) and BPH-related surgery were compared between the two groups. Incidences stratified by follow-up period, prostate-specific antigen (PSA), and prostate volume (PV) were compared between the two groups. RESULTS: The incidence of AUR was 13.6% (50/368) in the alpha-blocker group and 2.8% (7/252) in the combination group (p<0.001). A total of 8.4% (31/368) and 3.2% (8/252) of patients underwent BPH-related surgery in the alpha-blocker and combination groups, respectively (p=0.008). According to the follow-up period, the incidence of AUR was significantly decreased in combination group. However, the incidence of BPH-related surgery was significantly reduced after 7 years of combination therapy. Cutoff levels of PSA and PV for reducing the incidences of AUR and BPH-related surgery were 2.0 ng/ml and 35 g, respectively (p<0.001). CONCLUSIONS: Long-term combination therapy with alpha-blocker and 5-ARI can suppress the progression of BPH more efficiently than alpha-blocker monotherapy. For patients with BPH with PSA >2.0 ng/ml or PV >35 ml, combination therapy promises a better effect for reducing the risk of BPH progression.
