A 17-year-long community study looking at symptoms of enlarged prostate in over 2,000 men age 40 to 79 years suggests that surgery for benign prostatic hyperplasia (BPH) offers more relief from incontinence and obstruction symptoms than treatment from drug-based therapy, according to a new study by researchers at Mayo Clinic. The researchers presented their results today at the annual meeting of the American Urological Association.
Overall, results show:
- Urinary incontinence was a common condition, coexisting with BPH/lower urinary tract symptoms.
- In the community setting, patients with the highest symptom scores were most likely to receive surgical intervention.
- Symptoms stabilized and did not get worse after treatment of all kinds.
- Patients who underwent transurethral resection of the prostate (TURP) had the greatest decrease in both symptoms and incontinence compared to other treatment groups. Pre-TURP the incontinence rate was 64.5 percent and post-TURP it was 41.9 percent.
BPH and lower urinary tract symptoms, such as frequent urge to urinate or leakage, are common.
By age 60, an estimated 50 percent of all men suffer from enlarged prostate symptoms; by age 90, about
80 percent do. Multiple treatments exist. But data comparing drug therapy to surgery are lacking, making clinical decisions vulnerable to subjective factors.
From 1990 through 2007, the study enrolled 2,184 healthy men, age 40-79, living in Olmsted County, Minn., All participants completed surveys every other year about their urinary symptoms and the treatments they received. From this information, the investigators examined urinary problems and incontinence before and after different types of treatment.
Results showed that of the 2,184 men:
- 1,574 (72%) received no treatment for BPH symptoms.
- 307 (14%) took alpha adrenergic receptor blockers (α-ARs).
- 195 (9%) took the medication 5-alpha-reductase inhibitors (ARIs).
- 23 (1%) received surgical laser vaporization.
- 85 (4%) received surgical transurethral resection of the prostate (TURP).
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