title: Transurethral resection of the prostate: failure patterns and surgical outcomes in patients with symptoms refractory to alpha-antagonists.
abstract: BACKGROUND
  alpha-Antagonists (AAs) are ineffective in some men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Transurethral resection of the prostate (TURP) may be required. Reasons for AA failure and surgical outcomes in these patients have not been reported.
  
  
  METHODS
  We retrospectively reviewed cases of TURP for LUTS due to bladder outlet obstruction from 1995 to 1998. The TURP patients in whom AA therapy had failed (group 1) were compared with those who had symptomatic BPH but were not taking AAs (group 2). Comorbid conditions that might influence treatment results were considered, as were sizes of resection and pathologic results.
  
  
  RESULTS
  No differences occurred between groups 1 (n = 38) and 2 (n = 25) in age, length of postoperative follow-up, or resection size. However, outcomes were poorer in group 1 than in group 2. A trend toward greater comorbidity that might lead to voiding dysfunction, though not statistically significant, was seen in group 1.
  
  
  CONCLUSIONS
  Postoperative results of TURP may be less successful after AA therapy failure. This may be due to preoperative risk factors that affect voiding function rather than to prostatic size.
authors.affiliation: Department of Urology, Ochsner Clinic, New Orleans, LA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Blanchard
authors.forename: A
authors.initials: A
authors.lastname: Hananel
authors.forename: S
authors.initials: S
authors.lastname: Rutchik
authors.forename: J
authors.initials: J
authors.lastname: Sullivan
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D015897:Comorbidity; D017292:Doxazosin / Q000627:therapeutic use; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011224:Prazosin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D020728:Transurethral Resection of Prostate / Q000706:statistics & numerical data*; D017211:Treatment Failure; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery
chemical_list: D000317:Adrenergic alpha-Antagonists; C041226:Terazosin; D017292:Doxazosin; D011224:Prazosin