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KMID : 0358320100510070488
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Korean Journal of Urology
2010 Volume.51 No. 7 p.488 ~ p.491
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Prospective Factor Analysis of Alpha Blocker Monotherapy Failure in Benign Prostatic Hyperplasia
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Hong Kyoung-Pyo
Yoon Ha-Na
Chung Woo-Sik
Park Young-Yo
Byun Young-Joon
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Abstract
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Purpose: We aimed to determine the treatment of choice criteria for benign prostatic hyperplasia (BPH) by analyzing the factors causing alpha-adrenergic receptor blocker (α-blocker) monotherapy failure.
Materials and Methods: This retrospective study enrolled 129 patients with BPH who were prescribed an α-blocker. Patients were allocated to a transurethral resection of prostate (TURP) group (after having at least a 6-month duration of medication) and an α-blocker group. We compared the differences between the two groups for their initial prostate volume, serum prostate-specific antigen (PSA), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual urine volume (PVR).
Results: Of the 129 patients, 54 were in the TURP group and 75 were in the α-blocker group. Statistically significant differences (p<0.05) between the two groups were found in the prostate volume (50.8 ml vs. 34.4 ml), PSA (6.8 ng/ml vs. 3.6 ng/ml), Qmax (6.84 ml/sec vs. 9.99 ml/sec), and IPSS (27.3 vs. 16.8). According to the multiple regression analysis, the significant factors in α-blocker monotherapy failure were the IPSS (p<0.001) and prostate volume (p=0.015). According to the receiver operating characteristic (ROC) curve-based prediction regarding surgical treatment, the best cutoff value for the prostate volume and IPSS were 35.65 ml (sensitivity 0.722, specificity 0.667) and 23.5 (sensitivity 0.852, specificity 0.840), respectively.
Conclusions: At the initial diagnosis of BPH, patients with a larger prostate volume and severe IPSS have a higher risk of α-blocker monotherapy failure. In this case, combined therapy with 5-alpha-reductase inhibitor (5-ARI) or surgical treatment may be useful.
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KEYWORD
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Adrenergic alpha-antagonists, Prostatic hyperplasia, Transurethral resection of prostate
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