Duration of Medical Treatment of Benign Prostatic Hyperplasia: Impact on Urodynamics and Post-Prostatectomy Outcome

Objectives: The aim of this study was to assess whether the duration of preoperative benign prostatic hyperplasia (BPH) medication would affect the pressure flow study (PFS) parameters and the outcome of prostate surgery or not. Material and methods: A retrospective study involving patients with LUTS/BPH aged 50 years or older who were compliant with BPH medications. PFS was performed prior to prostate surgery to determine BOO degree and detrusor overactivity. The efficacy of prostate surgery was determined at 3 and 6 months after surgery using the I-PSS, QOL index, Q-max, and PVR. Patients were categorized into group A, who received treatment for 12 months or less, and group B, who received the treatment for 12 months or more. The categorization starts once the patient prefers surgical intervention. Results: A total of 114 patients were enrolled, 50 in group A and 64 patients in group B. The mean duration, in months, of medical treatment was 9.52 +/- 2.24 and 22.50 +/- 4.35 in group A and group B, respectively. Pdet@Qmax is significantly (p = 0.02) higher in patients of group B (63.85 +/- 11.34 vs. 94.75 +/- 19.53). The detrusor overactivity amplitude is slightly higher in group A (36.42 +/- 37.27 vs. 16.42 +/- 28.38) (p = 0.3). The mean I-PSS, Q-max, and PVR at 1, 3, and 6 months were comparable between the groups. Conclusion: After 24 months of BPH medical treatment, no profound PFS changes that may affect the decision of prostate surgery were observed. Patients who completed 24 months of medical treatment were safe as regards to detrusor muscle contractility with no urge to undergo prostate surgery earlier.