Korean J Urol.  2012 Apr;53(4):248-252.

alpha-Blocker Monotherapy and alpha-Blocker Plus 5-Alpha-Reductase Inhibitor Combination Treatment in Benign Prostatic Hyperplasia; 10 Years' Long-Term Results

• Shin TJ
• Kim CI
• Park CH
• Kim BH
• Kwon YK

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.

Keyword

Adrenergic alpha-1 receptor antagonists; 5-alpha reductase inhibitors; Prostatic hyperplasia

MeSH Terms

5-alpha Reductase Inhibitors
Adrenergic alpha-1 Receptor Antagonists
Follow-Up Studies
Humans
Incidence
Prostate
Prostate-Specific Antigen
Prostatic Hyperplasia
Urinary Retention
5-alpha Reductase Inhibitors
Adrenergic alpha-1 Receptor Antagonists
Prostate-Specific Antigen

Figure

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  FIG. 1 Cumulative incidences of acute urinary retention (AUR) in the α-blocker monotherapy and combination treatment groups.

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  FIG. 2 Cumulative incidences of benign prostatic hyperplasia (BPH) related surgery in the α-blocker monotherapy and combination treatment groups.

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