Sonographic Parameters Predicting the Outcome of Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia Treated with Alpha1-Adrenoreceptor Antagonist

OBJECTIVE - To define prostate and bladder sono-morphologic parameters that best predict the outcome of benign prostatic hyperplasia (BPH) in men treated with Alpha1-adrenoreceptor (AR) antagonist.

MEHTODS - BPH patients, candidates for medical treatment, were prospectively enrolled.

Beside basic evaluation measures, all patients underwent transrectal ultrasonography (TRUS). The main outcome was the response to treatment on the basis of International Prostatic Symptom Score (I-PSS), quality of life (QoL) score and maximum urine flow rate (Qmax) after taking daily oral dose of tamsulosin 0. 4 mg for 6-month. The influences of baseline parameters on treatment response were statistically analyzed.

RESULTS - A total of 166 patients completed the study. From them, 59 (35. 5%) had ineffective treatment after 6-month. According to logistic regression analysis, baseline I-PSS storage subscore, Qmax and TRUS-measured sono-morphologic parameters [bladder wall thickness (BWT), ultrasound estimated bladder weight (UEBW) and intravesical prostatic protrusion (IPP)] were the independent predictors of ineffective treatment (p

CONCLUSIONS - Sonographic measurement of BWT, UEBW and IPP might aid in determining BPH patients at high risk of Alpha1-AR antagonist mono-therapy failure; in turn determining the initial need for additional medical therapy or surgical intervention.

Urology. 2015 Nov 19 [Epub ahead of print]

Abul-Fotouh Ahmed

Department of Urology, Prince Suttam bin Abdulaziz University, Al-kharj, KSA; Department of Urology, Al-Azhar University, Cairo, Egypt.