Non-Responding Factors of Medical Treatment for Benign Prostatic Hyperplasia

Lim, Ji Seok; Shim, Bong Suk

Abstract

PURPOSE: Although adrenergic alpha-blockers were initially used for symptomatic benign prostatic hyperplasia (BPH), their failure rate was about 30% or less. We evaluated the clinical characteristics and the risk factors contributing to the failure of this treatment.
MATERIALS AND METHODS
Of 234 patients with BPH who were initially treated with adrenergic alpha-blockers, 84 (36%) were classified as non-responsive (Group II) following 3 months medical treatment. There were 150 patients with a good medical response (Group I). Prior to, and 3 months following medication, IPSS (International prostate symptom score) questionnaires, uroflowmetry, TRUS (Transurethral ultrasonography), height, weight, past medical history and life style factors, including smoking status, alcohol consumption, exercise and coffee consumption were checked. The TURP findings were taken from both the non-response and initial TURP groups (Group III).
RESULTS
There were no differences in risk and life style factors between the 3 groups. When comparing groups II and III, the bladder neck elevation (p=0.003), median lobe enlargement (p=0.016), prostate stone (p=0.004) and micro-abscess (p=0.003) were all significantly different. Statistical differences were obtained between groups I and II for the bladder neck elevation (p=0.002), and the median lobe enlargement (p=0.001) from cystourethroscopy. Prostate stones (p=0.006) were compared between the TRUS (group I) and TURP (group II) groups.
CONCLUSIONS
These findings clearly demonstrate that the BPH patients, classified as non responsive following 3 months of medical treatment, need cystoscopy or TRUS to find a more appropriate treatment.