PURPOSE:We compared the effects of alpha-adrenergic receptor blocker (α-blocker) monotherapy with those of combination therapy with α-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 α-blocker monotherapy (α-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 α-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 α-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 α-blocker and 5-ARI can suppress the progression of BPH more efficiently than α-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.
Written by:
Shin TJ, Kim CI, Park CH, Kim BH, Kwon YK. Are you the author?
Department of Urology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Reference: Korean J Urol. 2012 Apr;53(4):248-52.
doi: 10.4111/kju.2012.53.4.248
PubMed Abstract
PMID: 22536467
