title: Identification of baseline clinical factors which predict medical treatment failure of benign prostatic hyperplasia: an observational cohort study.
abstract: OBJECTIVE
  The aim of this study was to identify the clinical baseline factors that affect the long-term treatment failure of benign prostatic hyperplasia (BPH).
  
  
  METHODS
  437 men over 50 years of age with BPH were enrolled for this analysis. Patients were allocated to a medication and a surgical treatment (following medication) group. We initially examined the International Prostatic Symptom Score (IPSS), uroflow rate, prostate volume, postvoid residual volume, and the serum prostate specific antigen level as clinical baseline factors and analyzed differences between the two groups.
  
  
  RESULTS
  337 patients (77.1%) were given maintenance medical treatment during follow-up, and 100 patients (22.9%) had surgical treatment following medication. Statistically significant differences were found in IPSS and prostate volume between the surgical and medication groups (IPSS: 22.6+/-6.4 vs. 18.7+/-5.8, prostate volume (cm(3)): 36.3+/-14.4 vs. 30.1+/-11.0, respectively). According to the ROC curve-based prediction of the failure for medical therapy, the best cutoff values of IPSS and prostate volume were 21 (area under ROC curve: 0.67) and 32cm(3) (area under ROC curve: 0.65), respectively.
  
  
  CONCLUSIONS
  The results show that BPH patients with more severe IPSS and larger prostate volume have a higher risk of medical treatment failure, and suggest that the IPSS and prostate volume may be useful predictors of medical treatment maintenance.
authors.affiliation: Department of Urology, Yonsei University College of Medicine, Seoul 135-720, Republic of Korea.
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Hong
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Ko
authors.forename: Sun Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D018120:Finasteride / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000473:pathology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D017211:Treatment Failure; D016055:Urinary Retention / Q000175:diagnosis; D014563:Urodynamics
chemical_list: D000317:Adrenergic alpha-Antagonists; D018120:Finasteride