The aim of this study was to establish a tool to identify patients at risk for pharmaceutical and surgical interventions for benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) over a 10 year follow-up.
The data of patients with mild to moderate male LUTS undergoing phytotherapy from January to December 2010 were reviewed. Patients were followed for 10 years through medical visits and telephone consultations. The outcomes were (1) treatment switch from phytotherapy or no therapy to alpha-blockers or 5α-reductase inhibitors (5-ARI), and (2) clinical progression (acute urinary retention or need for surgery). Two calibrated nomograms (one for each outcome) were constructed on significant predictors at multivariate analysis.
A total of 107 patients with a median age of 55 years at presentation were included; 47% stopped or continued phytotherapy, while 53% switched to alpha-blockers and/or 5-ARI after a median time of 24 months. One-third in the second group experienced clinical progression after a median time of 54 months. Age, symptom score, peak flow rate (Qmax), prostate-specific antigen (PSA), and post-void residual volume were significantly associated with the outcomes. According to our nomograms, patients switching therapy or progressing clinically had average scores of 75% and 40% in the dedicated nomograms, respectively, as compared to 25% and <5% in patients who did not reach any outcome.
We developed a nomogram to predict the risk of pharmaceutical or surgical interventions for BPH-related LUTS at 10 years from presentation. On the basis of our models, thresholds of >75% and >40% for high risk and <25% and <5% for low risk of pharmaceutical or surgical interventions, respectively, can be proposed.
International journal of environmental research and public health. 2022 Aug 08*** epublish ***
Lorenzo G Luciani, Daniele Mattevi, Daniele Ravanelli, Umberto Anceschi, Guido Giusti, Tommaso Cai, Umberto Rozzanigo
Robotic Surgery Unit, S. Chiara Hospital, 38122 Trento, Italy., Department of Urology, S. Chiara Hospital, 38122 Trento, Italy., Health Physics Unit, S. Chiara Hospital, 38122 Trento, Italy., Department of Urology, IRCCS National Cancer Institute, Regina Elena, 00144 Rome, Italy., Department of Urology, IRCCS S. Raffaele Hospital, 20132 Milan, Italy., Department of Radiology, S. Chiara Hospital, 38122 Trento, Italy.