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Quality of life with pharmacological treatment in patients with benign prostatic enlargement: results from the Evolution European Prospective Multicenter Multi-National Registry Study

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Abstract

Background

Lower urinary tract symptoms due to benign prostate enlargement (LUTS/BPE) can lead to significant disturbances to health-related quality of life (HRQoL) and psychological well-being. The aim of this study was to evaluate the effect of pharmacological treatment of LUTS/BPE on disease specific and generic QOL measures.

Methods

Evolution was a European prospective, multicenter multi-national, observational registry collecting real-life clinical data over 2 years on the management of LUTS/BPE in primary and secondary care. This study investigated disease-specific QOL using questionnaires such as IPSS Q8, BPH Impact Index (BII) and generic QOL using questionnaires like EuroQOL Five Dimension (EQ5D) which encompassed EQ5D VAS and EQ5D health index.

Results

The registry enrolled 1838 BPE patients and 1246 patients were evaluable at the end of 24 months. Nearly 70% of patients in the study were previously treated with medical therapy and 17% of these had already discontinued medical treatment previously for various reasons with lack of efficacy being the most common. The mean time since diagnosis of LUTS in the previously treated group was 4.7 years (0–26 years). Medical management produced statistically significant improvement in QOL (disease specific and generic) in previously untreated patients and an insignificant change in generic QOL in previously treated patients.

Conclusions

After 5-years from the onset of symptoms, LUTS/BPE patients previously treated with medication had significantly impaired QOL in patients in a manner comparable to other chronic diseases. Earlier intervention with minimally invasive surgical techniques (MIT) should be considered in LUTS/BPE patients that do not show a significant improvement in QOL with medical therapy.

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Funding

The Evolution registry was supported by a restricted Grant from GlaxoSmithKline© (GSK).

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Authors and Affiliations

  1. Department of Urology, Ipswich Hospital, East Suffolk and North Essex Trust, Ipswich, Suffolk, IP45PD, England, UK

    Nikita R. Bhatt

  2. Department of Urology, Beaumont Hospital and Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland

    Niall F. Davis

  3. EAU Research Foundation, P.O. Box 30016, 6803 AA, Arnhem, The Netherlands

    W. P. Witjes, A. Bjartell & C. Caris

  4. Department of Urology, Skane Hospital, Lund University, Malmö, Sweden

    A. Bjartell

  5. Department of Urology, Spire London East Hospital, Roding Lane South, Redbridge, Essex, Ilford, IG4 5PZ, UK

    A. Patel

  6. Department of Urology, Assistance Publique Des Hopitaux de Paris, 54 Av du Mal de Lattre de Tassigny, 94000, Créteil, France

    A. de la Taille

  7. Department of Urology, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy

    A. Tubaro

Authors
  1. Nikita R. Bhatt
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  2. Niall F. Davis
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  3. W. P. Witjes
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  4. A. Bjartell
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  5. C. Caris
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  6. A. Patel
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  7. A. de la Taille
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  8. A. Tubaro
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Contributions

NRB: Data analysis and Manuscript writing. NFD: Data analysis and Manuscript editing and critical review. WPW: Project development, Data Collection, Manuscript editing and critical review. AB: Project development, Data Collection, Manuscript editing and critical review. CC: Project development, Data Collection, Manuscript editing and critical review. AP: Project development, Data Collection, Manuscript editing and critical review. AT: Project development, Data Collection, Manuscript editing and critical review. AT: Project development, Data Collection, Manuscript editing and critical review.

Corresponding author

Correspondence to Nikita R. Bhatt.

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None.

Research involving human participants and/or animals

Registry data, not research.

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Registry data, ethics obtained.

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Appendix

Appendix

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Patient inclusion and exclusion flow chart

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Bhatt, N.R., Davis, N.F., Witjes, W.P. et al. Quality of life with pharmacological treatment in patients with benign prostatic enlargement: results from the Evolution European Prospective Multicenter Multi-National Registry Study. World J Urol 39, 517–526 (2021). https://doi.org/10.1007/s00345-020-03219-7

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  • DOI: https://doi.org/10.1007/s00345-020-03219-7

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