SAN FRANCISCO--(BUSINESS WIRE)--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 (http://www.mayoclinic.org/bph/)
(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 (http://www.auanet.org/content/homepage/homepage.cfm).
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.
The findings provide large-sample, long-term data
comparing the effectiveness of medical versus surgical treatments in a
large, general population, as compared to small, select clinical
populations of men. “Our data fills a gap in the research record that
can be used by physicians and patients to evaluate management options,”
Krambeck, M.D. (http://www.mayoclinic.org/bio/13877739.html),
Mayo Clinic urologist and lead study investigator. “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.”
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
About the Study
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
Comments Dr. Krambeck: “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. Only the surgical TURP group reported a
decrease in incontinence — pre-TURP the incontinence rate was 64.5
percent and post-TURP it was 41.9 percent.” 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
Collaboration and Support
In addition to Dr. Krambeck, other
investigators are Debra Jacobson; Michaela McGree; Deborah
Lightner, M.D. (http://www.mayoclinic.org/bio/12412414.html);
Lieber, M.D. (http://www.mayoclinic.org/bio/10203567.html);
Steven Jacobsen, M.D.; Jennifer St. Sauver, Ph.D. Their work was funded
by the Mayo Foundation for Medical Education and Research and National
Institutes of Health.
To request an appointment at Mayo Clinic, please call 480-422-1490 for
the Arizona campus, 904-494-6484 for the Florida campus, or 507-216-4573
for the Minnesota campus.
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