title: Comparison of the clinical efficacy of medical treatment of symptomatic benign prostatic hyperplasia between normal and obese patients.
abstract: We aimed to investigate the difference in efficacy of medical treatment of symptomatic benign prostatic hyperplasia (BPH) between normal and obese patients with BPH; obesity was determined by either body mass index (BMI) or waist circumference (WC). In this 12-week prospective observational study, a total of 175 patients aged ≥40 years with International Prostate Symptom Scores (IPSS) ≥12 points and prostate volume ≥20 ml were prospectively enrolled. The patients were divided into two groups according to BMI or WC. Patients received the doxazosin gastrointestinal therapeutic system (GITS) at a dose of 4 mg once per day for 12 weeks. The changes from baseline in the IPSS, maximal urinary flow rate (Q(max)), post-void residual volume, quality of life (QoL) scores and adverse events (AEs) were analysed. Of the 175 enrolled patients, 132 completed the study. Sixty-seven patients had BMI >23 kg m⁻², and 43 had WC >90 cm. Obese patients represented by WC >90 cm or BMI ≥23 kg m⁻² had a significantly greater prostate volume compared with non-obese patients at baseline. Total IPSS was significantly higher in the WC >90 cm group compared to the WC ≤90 cm group. Total IPSS was positively correlated with prostate volume (P=0.031) and WC (P=0.045). All groups showed significant improvements in total IPSS and QoL at 12 weeks. However, the improvement of total IPSS was greater in the high-BMI and high-WC groups. The most frequent AE was dizziness (n=13), and it was significantly lower in the obese BPH patients. Obesity was associated with increased prostate volume and lower urinary tract symptoms. Alpha-blockers appear to be efficacious for controlling symptoms, especially in obese men.
authors.affiliation: Department of Urology, Yonsei University Health System, Seoul, Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Cheol Young
authors.initials: CY
authors.lastname: Oh
authors.forename: Kyung Kgi
authors.initials: KK
authors.lastname: Park
authors.forename: Mun Su
authors.initials: MS
authors.lastname: Chung
authors.forename: Se Jeong
authors.initials: SJ
authors.lastname: Yoo
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D015992:Body Mass Index; D016022:Case-Control Studies; D017292:Doxazosin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D017292:Doxazosin