Surgery outperforms drug therapy in BPH treatment

A 17-year-long community study looking at symptoms of BPH in more than 2,000 men aged 40 to 79 years suggests that surgery offers more relief from incontinence and symptoms of obstruction than treatment from drug-based therapy.

Researchers from Mayo Clinic, Rochester, MN, presented their findings at the AUA annual meeting. Overall, results showed:

• 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 worsen after treatment of all kinds.
• Patients who underwent transurethral resection of the prostate had the greatest decrease in both symptoms and incontinence compared with other treatment groups. Pre-TURP, the incontinence rate was 64.5% and post-TURP, it was 41.9%.

"Our data fills a gap in the research record that can be used by physicians and patients to evaluate management options," said first author Amy Krambeck, MD. "Because it’s a large community-based study of more than 2,100 men, it includes the entire broad range of male health. This suggests the results are stronger in terms of being generalized and applied to other men.

"After intervention, the greatest improvement in symptom score was seen in the TURP group, followed by laser vaporization, then the drugs: 5-alpha reductase inhibitors and alpha-adrenergic receptor blockers," she added. "Only the surgical TURP group reported a decrease in incontinence. This reduction in incontinence rates is significant when compared to the increase in reported incontinence in the patients receiving both forms of medical therapy and no change in symptoms for patients receiving laser vaporization."