OBJECTIVE - To determine whether conservative management of benign prostatic hyperplasia (BPH) is an appropriate option for patients with bladder stones.
METHODS - The study cohort comprised 34 men who underwent endoscopic bladder stone removal with subsequent conservative management of BPH, including watchful waiting and medical therapy (alpha-blocker ± dutasteride), between April 2006 and January 2014. We recorded BPH-related complications after stone removal and compared International Prostate Symptom Scores, quality of life scores, and postvoid residual urine volume before and after treatment. Cumulative BPH-related complication-free survival and the preoperative parameters associated with the occurrence of BPH-related complications were also analyzed.
RESULTS - Twenty-six patients (76.5%) treated with conservative management had no BPH-related complications, during a mean follow-up of 52.6 ± 30.9 months. Mean International Prostate Symptom Scores fell from 13.5 ± 7.1 before treatment to 9.7 ± 6.3 after treatment (P = .025). One of the 34 patients (2.9%) experienced recurrent urinary infections, 2 (5.9%) had urinary retention, and 6 (17.6%) developed recurrent bladder stones. The cumulative BPH-related complication-free survival was 97.0% at 1 year, 81.8% at 3 years, and 70.5% at 5 years. Six of the men (17.6%) underwent invasive intervention for BPH after occurrence of these complications. Prostate volume was the only preoperative parameter associated with the occurrence of complications after stone removal (P = .035).
COCLUSIONS - Conservative management of BPH can be an appropriate treatment option in men with bladder stones and concurrent mild-to-moderate lower urinary tract symptoms.
Urology. 2015 Jul 30. pii: S0090-4295(15)00383-0. doi: 10.1016/j.urology.2015.04.022. [Epub ahead of print]
Yoshida T1, Kinoshita H2, Nakamoto T1, Yanishi M1, Sugi M1, Murota T3, Matsuda T1.
1 Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital Hirakata, Japan.
2 Department of Urology and Andrology, Kansai Medical University, Hirakata Hospital Hirakata, Japan.
3 Department of Urology and Andrology, Kansai Medical University, Takii Hospital, Moriguchi, Japan.