title: Ultrasound image features of intravesical prostatic protrusion indicated failure of medication therapy of finasteride and doxazosin in patients with benign prostatic hyperplasia (LUTS/BPH).
abstract: BACKGROUND
  Intravesical prostatic protrusion (IPP) is a type of benign prostatic hyperplasia (BPH) adenoma, and it plays a critical role in the pathogenesis of bladder outlet obstruction in patients with lower urinary tract syndromes (LUTS/BPH).
  
  
  OBJECTIVE
  The goal of this study was to investigate the effect of a combination therapy with finasteride and doxazosin on IPP in BPU/LUTS patients.
  
  
  METHODS
  A total of 322 BPH patients with enlarged prostatic volume as well as moderate to severe symptom scores were enrolled and divided into four groups according to the degree of IPP (IPP > 10 mm, 5-10 mm, <5 mm and no IPP) in this study. Aggravated International Prostatic Symptom Score (IPSS), acute urinary retention or relevant urinary complications were considered as failure of the therapy. The degrees of IPP were recorded before and after 6 months of treatment. Student's t test and χ2were performed between the baseline and endpoint of the therapy.
  
  
  RESULTS
  The results showed that the total prostate volume (TPV) and transition zone volume (TZV) of the prostate decreased significantly after 6-month combination therapy (P < 0.05), while no significant changes in IPP were observed at that point (P > 0.05). Failure rates of the medication differed significantly among the four groups.
  
  
  CONCLUSIONS
  The study indicated that the combination therapy using finasteride and doxazosin could not reduce the degree of IPP. LUTS/BPH patients with IPP which contributes to the failure of medication tend to have a higher risk of progression.
authors.affiliation: Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Ultrasonography, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China.
authors.forename: Yunkai
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Nantong Rich Hospital, 2000 Xinghu Rd, Nantong, 226010, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
authors.affiliation: Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, China. kjjjjd_sjtu@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Kang
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D017292:Doxazosin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D018120:Finasteride / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D053448:Prostatism / Q000188:drug therapy / Q000209:etiology; D017211:Treatment Failure; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D064804:Urological Agents; D018120:Finasteride; D017430:Prostate-Specific Antigen; D017292:Doxazosin
keywords: Benign prostatic hyperplasia; International Prostatic Symptom Score; Intravesical prostatic protrusion; Ultrasound; Urodynamics