Investig Clin Urol.  2017 Sep;58(5):359-364. 10.4111/icu.2017.58.5.359.

Can men with prostates sized 80 mL or larger be managed conservatively?

• Lee A
• Lee HJ
• Foo KT

• KMID: 2388053
• DOI: http://doi.org/10.4111/icu.2017.58.5.359

Abstract

PURPOSE
To analyze the long-term clinical outcomes of men with large prostate sizes of 80 mL and greater who were managed conservatively.
MATERIALS AND METHODS
We retrospectively analyzed men with prostate sizes of 80 mL and greater from our electronic hospital database. Clinical parameters such as age, International Prostate Symptom Score (IPSS), quality of life (QoL) scoring, serum prostate-specific antigen (PSA), uroflowmetry variables, and transabdominal ultrasound findings were evaluated. These parameters were compared at entry to our study and at the patient's latest follow-up visit.
RESULTS
For the 50 men included in our analysis, mean age was 68 years, median PSA was 9.9 ng/mL, and median prostate volume was 94 mL. Seven men underwent upfront prostate surgery, whereas the other 43 were managed conservatively, predominantly with pharmacotherapy (98%). Only serum PSA, QoL scores, and postvoid residual urine demonstrated a significant reduction at the end of a median follow-up period of 62 months. Fourteen men (33%) were considered to have progressed clinically, with 8 experiencing retention of urine and 6 having symptomatic deterioration. Of the 35 men who were still receiving conservative treatment at the end of the follow-up period, 24 men (69%) had a peak flow rate of 10 mL/s or greater, a QoL score of 3 or less, and mild to moderate (IPSS, 0-19) symptoms.
CONCLUSIONS
Although the incidence of clinical progression in men with prostate sizes of 80 mL and greater is high, there is still a role for conservative management with pharmacotherapy.

Keyword

Conservative treatment; Natural history; Prostatic hyperplasia

MeSH Terms

Drug Therapy
Follow-Up Studies
Humans
Incidence
Male
Natural History
Prostate*
Prostate-Specific Antigen
Prostatic Hyperplasia
Quality of Life
Retrospective Studies
Ultrasonography
Prostate-Specific Antigen

Figure

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  Fig. 1 Diagram showing the recruitment of men into our study.

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