[Can PSA density predict the response to alpha-blockers in benign prostatic hyperplasia?].
OBJECTIVE
In BPH there is a growth of both glandular and stromal components. Most of adrenoceptors sites are in the fibromuscular stroma. So the higher is the stromal/epithelial ratio, the more effective will alpha-blockers be. There in an indirect way of stimating this ratio without performing a biopsy. Bearing in mind that PSA is produced by the prostatic epithelium, the lower PSA density (PSAd), the higher the stromal/epithelial ratio and the higher alpha-blocker activity. We pretend to study if PSAd is useful for predicting the response to alpha-blockers in BPH.


METHODS
We studied 75 patients suffering from prostatism and diagnosed of bladder outlet obstruction secondary to BPH through IPSS symptom score, digital rectal examination, PSA, uroflowmetry, and transrectal ultrasound. All of them received Alfuzosin, 5 mg twice daily during 3 months, and then were evaluated again with IPSS and uroflowmetry.


RESULTS
A statistically significant improvement was appreciated of the two studied parameters and in both groups of patient with regard to the pretreatment situation. A statistically significant better answer was also appreciated in the group of patient with smaller PSAd in comparison with the higher PSAd patients.


CONCLUSIONS
Our results show that PDAd is usefu to estimate the stroma/epithelium ratio, and therefore the clinical response to alpha-blockers.
Server Pastor
G
G
Servicio de Urología, Hospital Universitario Virgen de la Arrixaca, Murcia.
Nicolás Torralba
J A
JA
Bañón Pérez
V
V
Valdelvira Nadal
P
P
Rigabert Montiel
M
M
López Cubillana
P
P
Prieto González
A
A
García Hernández
J A
JA
Pérez Albacete
M
M
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000188:drug therapy*
D000317:Adrenergic alpha-Antagonists; D017430:Prostate-Specific Antigen