title: Prostatic urethral angle might be a predictor of treatment efficacy of α-blockers in men with lower urinary tract symptoms.
abstract: OBJECTIVE
  We investigated the association of the prostatic urethral angle (PUA) with peak urinary flow rate (Qmax) and the severity of lower urinary tract symptoms (LUTS) on the aging male. We also evaluated the effect of the PUA on the treatment efficacy of tamsulosin on men with LUTS.
  
  
  METHODS
  The records were obtained from a prospective database for first-visit male patients with LUTS in the outpatient department of our institution. These patients underwent a detailed physical examination and taking of medical history. A transrectal ultrasound was performed on these patients. The prostate size, length of intravesical prostatic protrusion (IPP), PUA, and International Prostate Symptom Score (IPSS) of the patients were evaluated. Uroflowmetry and a bladder scan for residual urine were also performed on every patient. Tamsulosin 0.2 mg per day was prescribed. The IPSS and uroflowmetry were reevaluated after they had received treatment for 3 months.
  
  
  RESULTS
  A total of 178 patients were included, and 149 of them completed this cohort study. The mean PUA was 48.32°±13.74°. The mean prostate volume was 39.19±20.87 mL, and the mean IPP was 5.67±7.85 mm. On multivariate linear regression analysis, the PUA was independently associated with the IPSS (P<0.001), Qmax (P=0.004), post-treatment IPSS change (P=0.032), and post-treatment Qmax change (P<0.001). However, the prostate volume and IPP were not associated with these clinical items.
  
  
  CONCLUSIONS
  The PUA is significantly associated with Qmax and IPSS in men with LUTS. The PUA is also inversely correlated with changes in Qmax and IPSS after tamsulosin treatment. Namely, the PUA might be a predictor for the treatment efficacy of α-blockers in aging men with LUTS.
authors: Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors: Chen-Pang
authors: CP
authors: Hou
authors: Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors: Chien-Lun
authors: CL
authors: Chen
authors: Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors: Yu-Hsiang
authors: YH
authors: Lin
authors: Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors: Yu-Lun
authors: YL
authors: Tsai
authors: Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors: Phei-Lang
authors: PL
authors: Chang
authors: Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors: Horng-Heng
authors: HH
authors: Juang
authors: Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors: Ke-Hung
authors: KH
authors: Tsui
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D006801:Humans; D016014:Linear Models; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications*; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology; D014554:Urination / Q000187:drug effects
chemical_list: D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin
keywords: International Prostate Symptom Score; benign prostatic hyperplasia; prostate; prostatic urethral