title: Conservative Treatment for Benign Prostatic Hyperplasia in Patients With Bladder Stones.
abstract: OBJECTIVE
  To determine whether conservative management of benign prostatic hyperplasia (BPH) is an appropriate option for patients with bladder stones.
  
  
  METHODS
  The study cohort comprised 34 men who underwent endoscopic bladder stone removal with subsequent conservative management of BPH, including watchful waiting and medical therapy (alpha-blocker ± dutasteride), between April 2006 and January 2014. We recorded BPH-related complications after stone removal and compared International Prostate Symptom Scores, quality of life scores, and postvoid residual urine volume before and after treatment. Cumulative BPH-related complication-free survival and the preoperative parameters associated with the occurrence of BPH-related complications were also analyzed.
  
  
  RESULTS
  Twenty-six patients (76.5%) treated with conservative management had no BPH-related complications, during a mean follow-up of 52.6 ± 30.9 months. Mean International Prostate Symptom Scores fell from 13.5 ± 7.1 before treatment to 9.7 ± 6.3 after treatment (P = .025). One of the 34 patients (2.9%) experienced recurrent urinary infections, 2 (5.9%) had urinary retention, and 6 (17.6%) developed recurrent bladder stones. The cumulative BPH-related complication-free survival was 97.0% at 1 year, 81.8% at 3 years, and 70.5% at 5 years. Six of the men (17.6%) underwent invasive intervention for BPH after occurrence of these complications. Prostate volume was the only preoperative parameter associated with the occurrence of complications after stone removal (P = .035).
  
  
  CONCLUSIONS
  Conservative management of BPH can be an appropriate treatment option in men with bladder stones and concurrent mild-to-moderate lower urinary tract symptoms.
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan. Electronic address: kinoshih@hirakata.kmu.ac.jp.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kinoshita
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakamoto
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yanishi
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Sugi
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Takii Hospital, Moriguchi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murota
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital, Hirakata, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000368:Aged; D015331:Cohort Studies; D000068538:Dutasteride / Q000627:therapeutic use; D004724:Endoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000150:complications / Q000601:surgery*; D057832:Watchful Waiting
chemical_list: D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists; D000068538:Dutasteride