Short-term subjective efficacy of doxazosin in predicting probability of prostatectomy in the management of benign prostatic hyperplasia in patients with severe symptoms
Article first published online: 22 OCT 2003
International Journal of Urology
Volume 10, Issue 11, pages 582–586, November 2003
How to Cite
CAM, K., AKMAN, Y., KAYIKCI, A., SENEL, F. and EROL, A. (2003), Short-term subjective efficacy of doxazosin in predicting probability of prostatectomy in the management of benign prostatic hyperplasia in patients with severe symptoms. International Journal of Urology, 10: 582–586. doi: 10.1046/j.1442-2042.2003.00711.x
- Issue published online: 22 OCT 2003
- Article first published online: 22 OCT 2003
- Received 7 January 2003; accepted 16 June 2003.
- benign prostatic hyperplasia;
Background: The severity of symptoms still constitutes the major indication for transurethral prostatectomy, despite the extensive utilization of medical treatments. The aim of the study presented here was to investigate the impact of doxazosin on symptoms in relation to the probability of consequent surgery in severely symptomatic patients.
Methods: Patients with an International Prostate Symptom Score (IPSS) between 18 and 35 were included in the study. The patients received 4 mg/day doxazosin, and subjective efficacy was assessed by IPSS at the first and third months. In addition, the patients were classified at the third month according to a single question regarding satisfaction with medical treatment in terms of symptom relief as ‘ineffective, no change, and effective’.
Results: A total of 178 patients constituted the study group. Mean total symptom scores were 24, 19 and 17 at baseline, first and third months, respectively (P < 0.05). According to results of the questionnaire, 23% of the patients claimed the treatment was ineffective, and subsequently, the majority of this group (93%) underwent prostatectomy in a year. In addition, 33% of the patients reported no change in their symptoms, while 44% reported that the medication was effective. However, after 1 year, 59% and 15% of these cases underwent surgical treatment, respectively. The probability of surgery in the ‘ineffective’ group was significantly higher compared to the remaining groups (P < 0.05).
Conclusion: The majority of patients with severe symptoms who were not satisfied with the medication at the 3rd month underwent surgery. This observation may provide a predictor for subsequent probability of prostatectomy. Therefore, reassessment of patients would be a cost-effective approach for the treatment of BPH in severely symptomatic patients.