Introduction

Since benign prostatic hyperplasia (BPH) is a chronic and refractory disease and medical therapy became a standard treatment for most BPH patients with mild to moderate lower urinary tract symptoms, adherence to and persistence with therapy are considered important factors for the success of the treatment. Monotherapy using alpha-adrenergic antagonist constitutes the largest portion of medical therapy for BPH. Therefore, we aimed to assess and predict patient-reported goal achievement after treatment of BPH patients with tamsulosin.

Methods

From November 2013 to October 2015, 272 patients initially diagnosed with BPH were prospectively enrolled in nine different centers. Before the treatment, subjective final goals were recorded by all patients. Every four weeks, the treatment outcomes were evaluated using international prostate symptom score (IPSS) and uroflowmetry. Patient-reported goal achievements were assessed after 12 weeks of treatment and risk factors for lower scores of goal achievement were assessed using logistic regression analysis.

Results

Of the enrolled patients, 179 patients completed the study and 42 patients set multiple goals (32 patients with 2 goals, 9 patients with 3 goals and 1 patient with 4 goals). The pretreatment patients’ goals included the nocturia improvement (n=63), weak urine stream improvement (n=52), frequency improvement (n=34), residual urine sense improvement (n=27), hesitancy improvement (n=22), well voiding (n=21), urgency improvement (n=11), and voiding-related discomfort improvement (n=2). Of the 179 patients, 129 patients (72.1%) reported that they achieved their primary goals after three months of medical therapy. Logistic regression analysis revealed that pretreatment quality of life (OR=8.621, 95% CI: 2.154-9.834), and improvement of quality of life (OR=6.740, 95% CI: 1.908-11.490) were independent predictors of patient-reported goal achievement after tamsulosin monotherapy.

Conclusions

Overall patient-reported goal achievement after medical therapy for BPH was high, and the scores of pretreatment quality of life and improvement of quality of life can be important factors to predict the achievement of treatment goals.

Funding

This work was conducted by the UROSTAR study group and supported by Astellas Korea