Efficacy of different modes of pharmacotherapy for men with lower urinary tract symptoms benign prostatic hyperplasia depending of androgenic status

Abstract

In a sample of 187 men (average age of 65,3 ± 3,2 years) conducted a comparative analysis of clinical and urodynamic efficacy and safety of different modes of pharmacotherapy (monotherapy, α-1 blocker (n = 40), 5-α-reductase inhibitor (n = 35), plant agent (n = 30), combination therapy α-1 blocker + 5-α-reductase inhibitor with additional androgen replacement therapy (ART) with testosterone undecanoate (n = 42) and without ART (n = 40)) in men with lower urinary tract symptoms benign prostatic hyperplasia (LUTS/BPH) depending on their androgenic status within 24 months. Efficiency standard pharmacotherapy for patients with LUTS/BPH without their androgenic status with proper selection of drugs averaged 70.2 %, the effects of monotherapy with α-1 adrenoblocker averaged 62.7 %, with 5-α-reductase inhibitor – 78.4 %, plant agent – 49.3 %, respectively (p < 0.05). The most effective type of treatment of LUTS/BPH in men regardless of their status was combination therapy with α-1 blockers and 5-α-reductase inhibitors, the effectiveness of which reached 82.4 % (p <0.05). Combination therapy with additional testosterone undecanoate showed significantly greater clinical and urodynamic effect (scale IPSS and maximum volume rate of urination for uroflowmetry) in hypogonadal men with LUTS/BPH compared with standard therapy of any drugs in any mode from patients regardless of their androgen status (p < 0.05). ART may be regarded as an effective and safe pathogenetic component of modern pharmacotherapy LUTS/BPH in men diagnosed with late-onset androgen deficiency (hypogonadism).

Keywords

• lower urinary tract symptoms
• benign prostatic hyperplasia
• late-onset androgen deficiency
• hypogonadism
• pharmacotherapy
• testosterone undecanoate