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Efficacy of alpha blocker treatment according to the degree of intravesical prostatic protrusion detected by transrectal ultrasonography in patients with benign prostatic hyperplasia.

Park HY, Lee JY, Park SY, Lee SW, Kim YT, Choi HY, Moon HS - Korean J Urol (2012)

Bottom Line: In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03).In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved.Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To analyze the effectiveness of tamsulosin 0.2 mg once daily for 3 months according to the degree of intravesical prostatic protrusion (IPP) in patients with benign prostatic hyperplasia (BPH).

Materials and methods: A total of 134 BPH patients over 40 years of age treated with tamsulosin 0.2 mg between January 2007 and January 2009 were enrolled retrospectively. The patients were classified into three groups according to the degree of IPP: below 5 mm (group A), between 5 and 10 mm (group B), and over 10 mm (group C). Prostate volume, prostate-specific antigen (PSA), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were evaluated before treatment. International Prostate Symptom Score and Quality of Life (IPSS/QoL), maximal urine flow rate (Qmax), and postvoid residual (PVR) volume were measured before treatment, and improvement in the three groups was compared after 3 months.

Results: The mean age of the patients was 65.01±7.38 years. Mean IPPs were 0.90±1.39 mm (group A, n=90), 6.92±1.10 mm (group B, n=24), and 16.60±4.06 mm (group C, n=20). Prostate volume, PUL, PAUL, PSA, Qmax, and PVR showed significant correlations with IPP (p<0.05), but not with IPSS/QoL score (p>0.05). Comparison of parameters before and after 3 months showed that medication improved total IPSS and subscores (p<0.001), QoL (p<0.001), Qmax (p<0.001), and PVR (p=0.030) in group A. In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03). In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved.

Conclusions: Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP.

No MeSH data available.


Related in: MedlinePlus

Grading system for intravesical prostatic protrusion (IPP). (A) Grade I (<5 mm), (B) Grade II (5-10 mm), and (C) Grade III (>10 mm) IPP. IPP, intravesical prostatic protrusion.
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Figure 1: Grading system for intravesical prostatic protrusion (IPP). (A) Grade I (<5 mm), (B) Grade II (5-10 mm), and (C) Grade III (>10 mm) IPP. IPP, intravesical prostatic protrusion.

Mentions: The study included 134 men over 40 years of age with lower urinary tract symptoms (LUTS) who visited our clinic between January 2007 and January 2009, retrospectively. All men underwent urinalysis, routine laboratory tests, measurement of prostate-specific antigen (PSA), uroflowmetry (Urodyn-1000; Medtronic Inc., West Palm Beach, FL, USA), 6.5 MHz probe TRUS (SA-8000, Medison, Seoul, Korea), and measurement of post-voided residual (PVR) volume by ultrasonography. In patients with PSA≥4 ng/ml, we performed TRUS-guided biopsies to rule out prostate cancer and enrolled the patients who were not diagnosed with prostate cancer. Degrees of initial International Prostate Symptom Scores and Quality of Life (IPSS/QoL) score, prostate volume, maximal urine flow rate (Qmax), and PVR were not considered as exclusion criteria. The following subjects were excluded from the study: those who had histories of gross hematuria, urinary tract infection, urinary tract stone disease, or pelvic surgery; those with a diagnosis of neurogenic bladder or urethral stricture; and those using anticholinergic agents and 5-alpha-reductase inhibitors. Using TRUS, retrospectively, we identified the bladder neck and protrusion of the prostate into the bladder according to the classification system of IPP as used by Nose et al. [5]. By measuring the vertical distance from the tip of the protrusion to the circumference of the bladder at the base of the prostate gland, we divided the patients into 3 groups according to the extent of IPP: those with an IPP of 5 mm or less (group A), those with an IPP of 5 to 10 mm (group B), and those with an IPP of greater than 10 mm (group C) (Fig. 1). Prostate volume, transitional zone volume (TZV), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were estimated by TRUS. PUL and PAUL were measured as the vertical distance from the base of the prostate gland to the apex of the prostate gland and to the apex of the prostate adenoma, respectively, by retrospective review. IPSS/QoL scores were obtained for all patients, and IPSS scores were subdivided according to irritative subscore and obstructive subscore. The scores on the first visit were compared with those obtained after administration of tamsulosin 0.2 mg for 3 months. Uroflowmetry measurements were also compared before and after tamsulosin administration.


Efficacy of alpha blocker treatment according to the degree of intravesical prostatic protrusion detected by transrectal ultrasonography in patients with benign prostatic hyperplasia.

Park HY, Lee JY, Park SY, Lee SW, Kim YT, Choi HY, Moon HS - Korean J Urol (2012)

Grading system for intravesical prostatic protrusion (IPP). (A) Grade I (<5 mm), (B) Grade II (5-10 mm), and (C) Grade III (>10 mm) IPP. IPP, intravesical prostatic protrusion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3285715&req=5

Figure 1: Grading system for intravesical prostatic protrusion (IPP). (A) Grade I (<5 mm), (B) Grade II (5-10 mm), and (C) Grade III (>10 mm) IPP. IPP, intravesical prostatic protrusion.
Mentions: The study included 134 men over 40 years of age with lower urinary tract symptoms (LUTS) who visited our clinic between January 2007 and January 2009, retrospectively. All men underwent urinalysis, routine laboratory tests, measurement of prostate-specific antigen (PSA), uroflowmetry (Urodyn-1000; Medtronic Inc., West Palm Beach, FL, USA), 6.5 MHz probe TRUS (SA-8000, Medison, Seoul, Korea), and measurement of post-voided residual (PVR) volume by ultrasonography. In patients with PSA≥4 ng/ml, we performed TRUS-guided biopsies to rule out prostate cancer and enrolled the patients who were not diagnosed with prostate cancer. Degrees of initial International Prostate Symptom Scores and Quality of Life (IPSS/QoL) score, prostate volume, maximal urine flow rate (Qmax), and PVR were not considered as exclusion criteria. The following subjects were excluded from the study: those who had histories of gross hematuria, urinary tract infection, urinary tract stone disease, or pelvic surgery; those with a diagnosis of neurogenic bladder or urethral stricture; and those using anticholinergic agents and 5-alpha-reductase inhibitors. Using TRUS, retrospectively, we identified the bladder neck and protrusion of the prostate into the bladder according to the classification system of IPP as used by Nose et al. [5]. By measuring the vertical distance from the tip of the protrusion to the circumference of the bladder at the base of the prostate gland, we divided the patients into 3 groups according to the extent of IPP: those with an IPP of 5 mm or less (group A), those with an IPP of 5 to 10 mm (group B), and those with an IPP of greater than 10 mm (group C) (Fig. 1). Prostate volume, transitional zone volume (TZV), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were estimated by TRUS. PUL and PAUL were measured as the vertical distance from the base of the prostate gland to the apex of the prostate gland and to the apex of the prostate adenoma, respectively, by retrospective review. IPSS/QoL scores were obtained for all patients, and IPSS scores were subdivided according to irritative subscore and obstructive subscore. The scores on the first visit were compared with those obtained after administration of tamsulosin 0.2 mg for 3 months. Uroflowmetry measurements were also compared before and after tamsulosin administration.

Bottom Line: In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03).In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved.Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To analyze the effectiveness of tamsulosin 0.2 mg once daily for 3 months according to the degree of intravesical prostatic protrusion (IPP) in patients with benign prostatic hyperplasia (BPH).

Materials and methods: A total of 134 BPH patients over 40 years of age treated with tamsulosin 0.2 mg between January 2007 and January 2009 were enrolled retrospectively. The patients were classified into three groups according to the degree of IPP: below 5 mm (group A), between 5 and 10 mm (group B), and over 10 mm (group C). Prostate volume, prostate-specific antigen (PSA), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were evaluated before treatment. International Prostate Symptom Score and Quality of Life (IPSS/QoL), maximal urine flow rate (Qmax), and postvoid residual (PVR) volume were measured before treatment, and improvement in the three groups was compared after 3 months.

Results: The mean age of the patients was 65.01±7.38 years. Mean IPPs were 0.90±1.39 mm (group A, n=90), 6.92±1.10 mm (group B, n=24), and 16.60±4.06 mm (group C, n=20). Prostate volume, PUL, PAUL, PSA, Qmax, and PVR showed significant correlations with IPP (p<0.05), but not with IPSS/QoL score (p>0.05). Comparison of parameters before and after 3 months showed that medication improved total IPSS and subscores (p<0.001), QoL (p<0.001), Qmax (p<0.001), and PVR (p=0.030) in group A. In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03). In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved.

Conclusions: Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP.

No MeSH data available.


Related in: MedlinePlus