In a nutshell
This study was carried out to look at the effect that drug treatments have on the quality of life (QoL) of patients with benign prostatic enlargement (BPE) and lower urinary tract symptoms (LUTS). The authors found that in patients with LUTS/BPE, surgery should be carried out earlier in patients who do not respond to medical therapy.
BPE is the non-cancerous increase in size of the prostate gland. BPE can cause LUTS such as frequent urination, trouble starting to urinate, and weak stream while urinating. Other symptoms include being unable to pass urine, or loss of bladder control. LUTS/BPE can lead to problems relating to the QoL and the mental health issues.Mental health symptoms can range from self-esteem issues to depression.
There are several different types of treatment for LUTS/BPE. These can start with lifestyle interventions, medical therapies such as alpha-blockers (used to relax the muscles of the bladder and around the prostate), and surgery. There are currently very few studies that have assessed the effectiveness of medical therapy in improving patient-reported QoL in patients with BPE/LUTS.
Methods & findings
1246 patients were included in this study. This study used self-reported questionnaires to assess the impact medical therapies had on patients with LUTS/BPE. The average follow-up was 24-months. The average time from diagnosis of LUTS in previously treated patients was 4.7 years.
66.78% of patients were previously treated with medical therapy. 17% of these had stopped medical therapy. The most common reason for stopping medical therapy was the lack of effectiveness of the treatment.
Medical therapy was successful in improving QoL in previously untreated patients. Medical therapy was not as effective in treating symptoms in previously treated patients.
The bottom line
The authors found that medical therapy was more effective in improving QoL in previously untreated patients with LUTS/BPE. The authors suggest that patients who are not satisfied with medical treatments should consider surgical procedures.
The fine print
This study was based on patient self-reporting. This study used data from European centers which may not translate well globally.
Published By :
World Journal of Urology
May 04, 2020