LOWER URINARY TRACT SYMPTOMS CAUSED BY BENIGN PROSTATIC HYPERPLASIA: RESULTS OF TREATMENT DEPENDING ON ANDROGEN STATUS

Abstract

Objective is to study and compare the effect of different regimes of drug therapy on prostate volume and residual urine volume in men with lower urinary tract symptoms caused by benign prostatic hyperplasia (LUTS/BPH), depending on their androgenic status. Materials and methods. Carried out a comparative analysis of the effect on the prostate volume and the residual urine volume of different pharmacotherapy regimes (monotherapy α -blocker (n = 40), inhibitor of 5α -reductase (n = 35), herbal medicine (n = 30), combination therapy, α -blocker and inhibitor of 5α -reductase (n = 40)) in men with LUTS/BPH with unspecified androgen status, as well as combination therapy of α -blocker, 5α -reductase inhibitor and testosterone undecanoate (n = 42) in men with LUTS/BPH and androgen deficiency within 24 months. The total number of patients was 187 (mean age 65.3 ± 3.2 yrs). Results. In routine practice, without taking into account the androgenic status of patients, the most pronounced reduction in prostate volume compared to the initial (by 26.6 %) was achieved through 24 months of monotherapy with 5α -reductase inhibitor (p <0.05). Against the background of monotherapy α -blocker for 24 months there was, on the contrary, an increase in the average volume of the prostate gland by 8.2 % (p <0.05), and in the group of monotherapy with herbal medicine – by 1.1 %. The average of residual urine volume against the background of monotherapy α -blocker decreased in 24 months by 35.4 %, in groups of monotherapy with inhibitor of 5α -reductase by 56.2 % and with herbal preparation – by 8.6 % (p <0.05). Combined therapy with the use of testosterone undecanoate in men with LUTS/BPH and androgen deficiency had a significantly more positive effect on prostate volume and residual urine volume compared to standard combination therapy, excluding androgen status patients (p <0.05). Conclusion. The additional positive effect of androgen replacement therapy on prostate volume and residual urine volume can significantly reduce the manifestations of infravesical obstruction.