Conservative Treatment for Benign Prostatic Hyperplasia in Patients With Bladder Stones

Abstract

To determine whether conservative management of benign prostatic hyperplasia (BPH) is an appropriate option for patients with bladder stones. The study cohort comprised 34 men who underwent endoscopic bladder stone removal with subsequent conservative management of BPH, including watchful waiting and medical therapy (alpha-blocker ± dutasteride), between April 2006 and January 2014. We recorded BPH-related complications after stone removal and compared International Prostate Symptom Scores, quality of life scores, and postvoid residual urine volume before and after treatment. Cumulative BPH-related complication-free survival and the preoperative parameters associated with the occurrence of BPH-related complications were also analyzed. Twenty-six patients (76.5%) treated with conservative management had no BPH-related complications, during a mean follow-up of 52.6 ± 30.9 months. Mean International Prostate Symptom Scores fell from 13.5 ± 7.1 before treatment to 9.7 ± 6.3 after treatment (P = .025). One of the 34 patients (2.9%) experienced recurrent urinary infections, 2 (5.9%) had urinary retention, and 6 (17.6%) developed recurrent bladder stones. The cumulative BPH-related complication-free survival was 97.0% at 1 year, 81.8% at 3 years, and 70.5% at 5 years. Six of the men (17.6%) underwent invasive intervention for BPH after occurrence of these complications. Prostate volume was the only preoperative parameter associated with the occurrence of complications after stone removal (P = .035). Conservative management of BPH can be an appropriate treatment option in men with bladder stones and concurrent mild-to-moderate lower urinary tract symptoms.