The Effect of Alpha1-blockers according to Histological Compositions in Patients with Benign Prostatic Hyperplasia

Kang, Heung Won; Park, Choal Hee; Kim, Chun Ill; Cho, Seung Che

Abstract

PURPOSE: Benign prostatic hyperplasia(BPH) describes a hyperplastic process of the stromal and epithelial elements of the prostate. The proliferative rates of each compartment in BPH may vary individually and the prostate is topographically not affected in a uniform way. The proposed mechanism of alphas-blockers in the treatment of BPH is the decrease of prostatic urethral resistance by relaxing the prostatic smooth muscle component present in the stroma. The purpose of this study is to search the effect of alphas-blockers according to histologic compositions in patients with BPH.
MATERIALS AND METHODS
From January 1994 to June 1997, 74 patients were treated with alpha1-blockers(> or =1month) before prostatectomy. Of 74 patients, the international prostate symptom score(IPSS) was used in 62 patients to evaluate the severity of voiding difficulties. The clinical response to alpha1-blockers was based upon change in IPSS during medication period. According to histological compositions of prostatectomy specimen, the patients were classified into three groups: predominantly stromal type(20 patients), predominantly glandular type(21 patients) and mixed type(21 patients).
RESULTS
There were 17 patients In response group and 45 patients in nonresponse group. The stromal type, glandular type and mixed type were composed of 52.9%, 17.7% and 29.4% respectively in response group and 24.4%, 40.1% and 35.5% respectively in nonresponse group. There was not statistical significant differences between clinical response of the alpha1-blockers and histologic compositions in patients with BPH(p>0.05).
CONCLUSIONS
Although stromal type was predominant in response group and glandular type was predominant in nonresponse group, the relationship between the effects of alpha1-blockers and histologic compositions in patients with BPH was not statistically significant. Further evaluation will be necessary to assess the association between effects of alpha1-blockers and histologic difference of prostate in patients with BPH.