title: α-blocker monotherapy and α-blocker plus 5-alpha-reductase inhibitor combination treatment in benign prostatic hyperplasia; 10 years' long-term results.
abstract: OBJECTIVE
  We compared the effects of alpha-adrenergic receptor blocker (α-blocker) monotherapy with those of combination therapy with α-blocker and 5-alpha-reductase inhibitor (5-ARI) on benign prostatic hyperplasia (BPH) progression for over 10 years.
  
  
  METHODS
  A total of 620 patients with BPH who received α-blocker monotherapy (α-blocker group, n=368) or combination therapy (combination group, n=252) as their initial treatment were enrolled from January 1989 to June 2000. The incidences of acute urinary retention (AUR) and BPH-related surgery were compared between the two groups. Incidences stratified by follow-up period, prostate-specific antigen (PSA), and prostate volume (PV) were compared between the two groups.
  
  
  RESULTS
  The incidence of AUR was 13.6% (50/368) in the α-blocker group and 2.8% (7/252) in the combination group (p<0.001). A total of 8.4% (31/368) and 3.2% (8/252) of patients underwent BPH-related surgery in the α-blocker and combination groups, respectively (p=0.008). According to the follow-up period, the incidence of AUR was significantly decreased in combination group. However, the incidence of BPH-related surgery was significantly reduced after 7 years of combination therapy. Cutoff levels of PSA and PV for reducing the incidences of AUR and BPH-related surgery were 2.0 ng/ml and 35 g, respectively (p<0.001).
  
  
  CONCLUSIONS
  Long-term combination therapy with α-blocker and 5-ARI can suppress the progression of BPH more efficiently than α-blocker monotherapy. For patients with BPH with PSA >2.0 ng/ml or PV >35 ml, combination therapy promises a better effect for reducing the risk of BPH progression.
authors.affiliation: Department of Urology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Teak Jun
authors.initials: TJ
authors.lastname: Shin
authors.forename: Chun Il
authors.initials: CI
authors.lastname: Kim
authors.forename: Choal Hee
authors.initials: CH
authors.lastname: Park
authors.forename: Byung Hoon
authors.initials: BH
authors.lastname: Kim
authors.forename: Young Kee
authors.initials: YK
authors.lastname: Kwon