title: 5-alpha-reductase inhibitor therapy postpones urine retention and prostate surgery in patients with prostate enlargement and a maximum uroflow rate of less than 15 ml/sec.
abstract: BACKGROUND
  This study investigated the risk of transurethral resection of prostate (TURP) and acute urine retention (AUR) in relation to 5-alpha-reductase inhibitor (5ARI) therapy.
  
  
  METHODS
  We identified 22,687 patients who were newly diagnosed with PE and low urinary tract symptoms (LUTS) between January 1, 2002 and December 31, 2011. We further classified study subjects who had moderate to severe LUTS and a maximum uroflow rate of less than 15ml/sec into three groups by their defined daily dose (DDD) of 5ARI used. The control group consisted of 7-28 cumulative DDD (cDDD) 5ARI users, while the short-term treatment group was 29-179cDDD 5ARI users, and the long-term treatment group was users of more than 180cDDD 5ARI. Each patient was monitored to identify those who subsequently developed TURP and AUR.
  
  
  RESULTS
  TURP and AUR are detected in 5.6% of control group, 7.6% of short-term treatment group and 5.5% of long-term treatment group during 10-year follow up. Compared with the control group, there was no difference in the risk of TURP and AUR in the short-term and long-term treatment groups (HR = 1.41, 95% CI 0.76 to 2.62 and HR = 0.81, 95% CI 0.42 to 1.56, respectively).
  
  
  CONCLUSIONS
  5ARI therapy did not change the risk of TURP and AUR events in patients with PE, moderate to severe LUTS and a maximum uroflow rate of less than 15 ml/sec in 10 years of follow-up. But long-term 5ARI used can postpone AUR and TURP for 8.16 months.
authors.affiliation: Department of Urology, Nantou Hospital, Ministry of Health and Welfare, Nantou, Taiwan.
authors.forename: Wenhsu
authors.initials: W
authors.lastname: Lin
authors.affiliation: Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Shangsen
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|School of Medicine, Tzu Chi University, Hualian, Taiwan.|Department of Research, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
authors.forename: Jengyuan
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Research, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
authors.forename: Yuhung
authors.initials: Y
authors.lastname: Kuo
authors.affiliation: Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|School of Medicine, Tzu Chi University, Hualian, Taiwan.|Department of Research, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
authors.forename: Tengfu
authors.identifier: http://orcid.org/0000-0003-0535-7239
authors.initials: T
authors.lastname: Hsieh
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use*; D000368:Aged; D016208:Databases, Factual; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D011467:Prostate / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D012306:Risk; D012720:Severity of Illness Index; D013624:Taiwan; D013997:Time Factors; D020728:Transurethral Resection of Prostate; D016055:Urinary Retention / Q000503:physiopathology / Q000517:prevention & control* / Q000601:surgery
chemical_list: D058891:5-alpha Reductase Inhibitors