Long-Term Risk Of Re-Treatment Of Patients Using ??-Blockers For Lower Urinary Tract Symptoms

Abstract

Patients given alpha-blockers for lower urinary tract symptoms have a high risk of re-treatment. Tamsulosin has a markedly lower re-treatment percentage than alfuzosin and terazosin. Severe symptoms, poor urine flow, an enlarged prostate and urodynamically proven bladder outlet obstruction increase the risk of treatment failure. Preselection of the most suitable candidates for alpha-blockade may reduce this risk.

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

“…8 A similar result was reported where the discontinuation rates were 64% after 3 years and 79% after 5 years of follow up after administration of a1-blockers. 13 Thus, all men who receive a1-blockers do not necessarily continue the same medication for a long time. However, the patients who could continue tamsulosin showed durable symptomatic improvement for 5 years, as shown in several previous reports.…”

“…20 Several static and dynamic variables to predict treatment failure and conversion to surgery of a1-blockers have been reported. 5,8,13,14,21 De la Rosette showed that static variables, such as a severe IPSS, poor Qmax, an enlarged prostate and BOO on pressureflow study, were risk factors for treatment failure. 13 They also showed that a higher PSA value and larger PV resulted in a greater risk of BPH-related invasive therapy.…”

“…5,8,13,14,21 De la Rosette showed that static variables, such as a severe IPSS, poor Qmax, an enlarged prostate and BOO on pressureflow study, were risk factors for treatment failure. 13 They also showed that a higher PSA value and larger PV resulted in a greater risk of BPH-related invasive therapy. 22 Previously, we demonstrated in our retrospective study using naftopidil that patients having a PV Ն35 mL and severe IPSS at 12 weeks after administration of the drug had 2.1-fold and 3.5-fold higher probabilities of treatment failure, respectively.…”

BPH’nın Progresyonunu Öngörebilir Miyiz?

“…Büyük prostat ve yüksek PSA düzeyi olan kişilerde tek başına alfa bloker ajanların yetersiz kaldığı gösterilmiştir (20). Alfa bloker ile tedavi başarısızlığı prostat volümü 40 ml üzerinde ise %72, 40 ml altında ise %48 bulunmuştur (21).…”

Dutasteride: an evidence-based review of its clinical impact in the treatment of benign prostatic hyperplasia

“…Smooth muscle tone in the bladder, prostatic urethra, prostate gland, and prostatic capsule is the dynamic component and accounts for up to 40% of the obstruction seen in BPH (de la Rosette et al 2002). The static component of bladder outlet obstruction is prostate enlargement characterized by the increase in total volume and the transitional zone volume of the prostate gland.…”