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Prospective factor analysis of alpha blocker monotherapy failure in benign prostatic hyperplasia
- Prospective factor analysis of alpha blocker monotherapy failure in benign prostatic hyperplasia
- Hong K.P.; Byun Y.J.; Yoon H.; Park Y.Y.; Chung W.S.
- Ewha Authors
- 박영요; 정우식; 윤하나; 변영준
- SCOPUS Author ID
- 박영요; 정우식; 윤하나
- Issue Date
- Journal Title
- Korean Journal of Urology
- vol. 51, no. 7, pp. 488 - 491
- SCOPUS; KCI
- 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 ?-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 ?-blocker monotherapy failure. In this case, combined therapy with 5-alpha-reductase inhibitor (5-ARI) or surgical treatment may be useful. © The Korean Urological Association, 2010.
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