title: Efficacy of alpha blocker treatment according to the degree of intravesical prostatic protrusion detected by transrectal ultrasonography in patients with benign prostatic hyperplasia.
abstract: OBJECTIVE
  To analyze the effectiveness of tamsulosin 0.2 mg once daily for 3 months according to the degree of intravesical prostatic protrusion (IPP) in patients with benign prostatic hyperplasia (BPH).
  
  
  METHODS
  A total of 134 BPH patients over 40 years of age treated with tamsulosin 0.2 mg between January 2007 and January 2009 were enrolled retrospectively. The patients were classified into three groups according to the degree of IPP: below 5 mm (group A), between 5 and 10 mm (group B), and over 10 mm (group C). Prostate volume, prostate-specific antigen (PSA), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were evaluated before treatment. International Prostate Symptom Score and Quality of Life (IPSS/QoL), maximal urine flow rate (Qmax), and postvoid residual (PVR) volume were measured before treatment, and improvement in the three groups was compared after 3 months.
  
  
  RESULTS
  The mean age of the patients was 65.01±7.38 years. Mean IPPs were 0.90±1.39 mm (group A, n=90), 6.92±1.10 mm (group B, n=24), and 16.60±4.06 mm (group C, n=20). Prostate volume, PUL, PAUL, PSA, Qmax, and PVR showed significant correlations with IPP (p<0.05), but not with IPSS/QoL score (p>0.05). Comparison of parameters before and after 3 months showed that medication improved total IPSS and subscores (p<0.001), QoL (p<0.001), Qmax (p<0.001), and PVR (p=0.030) in group A. In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03). In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved.
  
  
  CONCLUSIONS
  Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP.
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Park
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: Sung Yul
authors.initials: SY
authors.lastname: Park
authors.forename: Seung Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Yong Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Hong Yong
authors.initials: HY
authors.lastname: Choi
authors.forename: Hong Sang
authors.initials: HS
authors.lastname: Moon