Comparison of the Long Term Effect of Alpha-Blocker Only and 5-Alpha Reductase Inhibitor Combination Treatment on Acute Urinary Retention and Prostatic Surgery for Patients with Benign Prostatic Hyperplasia

Abstract

Purpose: The medical treatment for benign prostatic hyperplasia (BPH) had recently been directed at preventing the progression of BPH, which reduces the risk of acute urinary retention (AUR) and BPH-related surgery. This study compared the long-term effectiveness of administering alphaadrenergic blocker (α-blocker) and finasteride, a 5-alpha reductase inhibitor (5ARI), for treating BPH to prevent AUR and BPH-related surgery in real-life clinical practice. Materials and Methods: This retrospective study enrolled 166 BPH patients who were treated at our hospital with the α-blockers doxazosin, terazosin, prazosin and alfuzosin, or tamsulosin and 5ARI as their first BPH treatment between January 1997 and December 1997, and these treatments lasted at least 12 months. Using follow-up data that was obtained at up to 7 years after treatment, we calculated the AUR and BPH-related surgery percentages in the α-blocker only group and in the combination group. Results: During the study period, 17 of 110 patients (15.5%) in the αblocker only group and 4 of 56 patients (7.1%) in the combination group experienced AUR. BPH-related surgery was performed on 10 of 110 patients (9.1%) in the α-blocker only group and surgery was performed on 1 of 56 patients (1.8%) in the combination group. Among them, 5 patients in the α-blocker only group and 1 patient in the combination group received surgery for AUR, and another 5 patients in the α-blocker only group showed insufficient therapeutic response. Conclusions: Real-life clinical practice showed that long-term combination treatment with α-blockers and 5ARI reduced the risk of the progression of BPH, such as AUR or BPH-related surgery, as compared with α-blocker-only treatment. (Korean J Urol 2006;47:7-12)