Change in International Prostate Symptom storage subscore after long-term medical therapy in BPH patients: finasteride and alpha-blocker combination therapy in men with moderate-to-severe LUTS/BPH in Korea.
OBJECTIVE
To evaluate the efficacy and the change of International Prostate Symptom Score (IPSS) storage subscore after combination therapy (α-blocker and finasteride) in patients with lower urinary tract symptoms (LUTS) consistent with moderate-to-severe benign prostatic hyperplasia (BPH) and compared with α-blocker-only treatment.


METHODS
A total of 1315 patients seen in 5 urology centers in Korea from January 2001 to August 2007, with LUTS secondary to BPH were enrolled. Patients were divided into 4 groups according to treatment pattern (α-blocker monotherapy vs combination therapy) and IPSS storage subscores (≥6 vs <6). The changes from baseline in prostate volume, prostate-specific antigen concentration, IPSS, and Q(max.) were analyzed. We also determined the statistical differences among 4 groups in the IPSS, Q(max.), quality of life score (QoL), and prostate volume.


RESULTS
Of the 1315 men, 217 (16.5%) completed the month 48 visit. All groups showed significant improvements in the IPSS total score, IPSS voiding subscores, and QoL at 1 year. However, the high storage subscore group at baseline showed a significantly higher improvement in IPSS total scores and IPSS voiding subscores compared with the low storage subscore group at year 4. IPSS storage subscores were improved only in patients with high storage subscores at baseline, especially in combination treatment group. The mean change in QoL score from baseline to year 4 was significantly improved in high storage subscore groups.


CONCLUSIONS
Data from this retrospective analysis suggest that long-term combination treatment would be beneficial, especially to patients with severe storage symptoms at baseline.
Lee
Ji Youl
JY
Department of Urology, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Lee
Seung Hwan
SH
Kim
Su Jin
SJ
Kim
Choung-Soo
CS
Lee
Hyun Moo
HM
Kim
Cheon Il
CI
Chung
Byung Ha
BH
D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use*; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D004359:Drug Therapy, Combination; D018120:Finasteride / Q000627:therapeutic use*; D006801:Humans; D007723:Korea; D008297:Male; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D053448:Prostatism / Q000150:complications* / Q000175:diagnosis*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists; D018120:Finasteride