Background: Currently, α-blocker is becoming first-line drug therapy for benign prostatic hyperplasia (BPH). Although highly effective results are obtained with this therapy, a difference between the objective and subjective response rates is reported. To prevent unnecessary medical treatment and to predict the α-blocker response, we characterized the clinical features of α-blocker responders in men with BPH. Methods: Twenty-two men were consecutively enrolled in this study and received tamsulosin 0.2 mg once daily for 4–6 weeks. The primary measures of efficacy were maximum urinary flow rate (Qmax) determined from the flow measurements and international prostate symptom score (IPSS). Those with an increase in Qmax of ≧30% from baseline and a decrease in IPSS of ≧25% from baseline were defined as Qmax responders and IPSS responders, respectively. Clinical findings such as age, pretreatment IPSS and Qmax, serum prostate-specific antigen (PSA), total prostate volume, transition zone (TZ) volume, TZ index and T2-weighted magnetic resonance image (MRI) of the prostate TZ were compared between responders and non-responders for both criteria. Results: In 17 of 22 (77.2%) patients IPSS improved by ≧25%. In 9 of 22 (40.9%) patients Qmax improved by ≧30%. There were no differences in clinical findings between IPSS responders and non-responders. On the contrary, Qmax responders showed smaller total prostate and TZ volumes, a smaller TZ index and a lower intensity of the TZ in MRI than Qmax non-responders. Conclusions: Determination of the prostate volume and MRI findings of the inner prostate gland were useful in predicting Qmax responders to the α-blocker in men with BPH. In contrast, there were no clinical characteristics of the IPSS responders. IPSS responders without a Qmax response should be closely followed while continuing the α-blocker therapy for a long duration.

Keywords:
Prostate, α-Blocker, Benign prostatic hyperplasia, Magnetic resonance imaging, Transition zone, Smooth muscle cell
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© 2002 S. Karger AG, Basel
2002
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