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Ultrasound image features of intravesical prostatic protrusion indicated failure of medication therapy of finasteride and doxazosin in patients with benign prostatic hyperplasia (LUTS/BPH)

  • Urology - Original Paper
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Abstract

Background

Intravesical prostatic protrusion (IPP) is a type of benign prostatic hyperplasia (BPH) adenoma, and it plays a critical role in the pathogenesis of bladder outlet obstruction in patients with lower urinary tract syndromes (LUTS/BPH).

Aims

The goal of this study was to investigate the effect of a combination therapy with finasteride and doxazosin on IPP in BPU/LUTS patients.

Methods

A total of 322 BPH patients with enlarged prostatic volume as well as moderate to severe symptom scores were enrolled and divided into four groups according to the degree of IPP (IPP > 10 mm, 5–10 mm, <5 mm and no IPP) in this study. Aggravated International Prostatic Symptom Score (IPSS), acute urinary retention or relevant urinary complications were considered as failure of the therapy. The degrees of IPP were recorded before and after 6 months of treatment. Student’s t test and χ 2 were performed between the baseline and endpoint of the therapy.

Results

The results showed that the total prostate volume (TPV) and transition zone volume (TZV) of the prostate decreased significantly after 6-month combination therapy (P < 0.05), while no significant changes in IPP were observed at that point (P > 0.05). Failure rates of the medication differed significantly among the four groups.

Conclusions

The study indicated that the combination therapy using finasteride and doxazosin could not reduce the degree of IPP. LUTS/BPH patients with IPP which contributes to the failure of medication tend to have a higher risk of progression.

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Acknowledgements

We wish to thank all patients for their ongoing participation in this study. We appreciate Miss Tamara S Adams (Cancer Genomics, Wake Forest University School of Medicine, USA) for her kind devotion of checking and modifying the paper.

Funding

The present study was partly funded by the research of “SNPS in prediction of prostatic disease and the sensitivity to endocrinal therapy,” which was sponsored by the Science and Technology Commission of Shanghai Municipality (Project No. 11ZR1424100), and “Influence of SNPS in Drug Therapy for Large Sample of BPH Patients,” which was sponsored by the Key Project of the National Natural Science Foundation of China (Project No. 81070600).

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    Authors and Affiliations

    1. Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China

      Qiang Liu, Jun Qi & Jian Kang

    2. Department of Ultrasonography, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China

      Yunkai Zhu

    3. Department of Radiology, Nantong Rich Hospital, 2000 Xinghu Rd, Nantong, 226010, China

      Jianping Liu

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    1. Qiang Liu
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    Correspondence to Jian Kang.

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    Conflict of interest

    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Qiang Liu, Yunkai Zhu and Jianping Liu have contributed equally to this work.

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    Liu, Q., Zhu, Y., Liu, J. et al. Ultrasound image features of intravesical prostatic protrusion indicated failure of medication therapy of finasteride and doxazosin in patients with benign prostatic hyperplasia (LUTS/BPH). Int Urol Nephrol 49, 399–404 (2017). https://doi.org/10.1007/s11255-016-1478-6

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