uti Urogenital Tract Infection Urogenit Tract Infect 2465-8243 2465-8510 Korean Association of Urogenital Tract Infection and Inflammation 10.14777/uti.2018.13.02.40 uti-13-40 Original Article Effect of Alpha-Blockers on Patients with Benign Prostatic Hyperplasia with Inflammatory Cells in the Prostatic Fluid SeoYu-Mi KimHyung-Jee Department of Urology, Dankook University College of Medicine, Cheonan, Korea Correspondence to: Hyung-Jee Kim http://orcid.org/0000-0002-7993-1881 Department of Urology, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan 31116, Korea Tel: +82-41-550-6630, Fax: +82-41-556-7060 E-mail: killtumor@dankook.ac.kr 082018 19082018 13240 44 30042018 27062018 04082018 Copyright © 2018 Korean Association of Urogenital Tract Infection and Inflammation 2018 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose:

To determine if alpha-blocker monotherapy is effective on patients with benign prostatic hyperplasia (BPH) and prostatic inflammation.

 Materials and Methods:

Patients who were admitted for the treatment of lower urinary tract symptoms for 18 months were enrolled in this study. All were subjected to an International Prostate Symptom Score (IPSS) evaluation, prostate specific antigen analysis, urinalysis, residual urine testing, prostate massage, and transrectal prostate ultrasonography. The presence of inflammation in the secretion after the prostate massage was observed at high magnification. Patients with a leukocyte count of more than 15 were diagnosed as positive and classified as group 1 (experimental group), whereas those with a leukocyte count of less than 15 were diagnosed as negative and classified as group 2 (control group). Silodosin was administered (4 mg twice a day for two months).

 Results:

Group 1: After one and two months, there was no significant difference in the maximum urinary flow rate (Qmax) and post-void residual volume (PVR) compared to the baseline. The total IPSS was significantly improved over the 8-week study period. All symptoms except for Qmax and PVR showed significant improvement in the second month. Group 2: After one and two months, significant improvement was observed in all domains of the IPSS, and Qmax and PVR assessment, except for the PVR at one month.

 Conclusions:

In patients with BPH who have not been treated properly, other treatments based on prostatitis may be needed in addition to alpha blockers if there is inflammation on expressed secretion of prostate.

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Changes in the International Prostate Symptom Score (IPSS) of all patients

  Baseline First month Second month p-valuea) p-valueb) p-valuec)
IPSS, total 20.1±6.7 16.7±7.6 13.1±6.9 0.034 0.001 0.001
IPSS, voiding symptom 12.7±4.7 9.8±5.0 7.2±4.5 0.033 0.001 0.001
IPSS, storage symptom 8.0±3.3 6.9±3.4 5.7±3.2 0.047 0.001 0.002
IPSS, quality of life 4.5±1.1 3.9±1.3 3.2±1.2 0.005 0.001 0.001
Qmax (ml/sec) 10.8±4.1 12.5±6.3 13.0±4.8      
PVR (ml) 55.5±51.2 48.1±44.8 44.2±33.0      

Values are presented as mean±standard deviation.

Qmax: maximum urinary flow rate, PVR: post-void residual volume.

p-value compared baseline to the first month.

p-value compared baseline to the second month.

p-value compared first month to the second month.

Changes in the International Prostate Symptom Score (IPSS) of the experimental group (group 1)

  Baseline First month Second month p-valuea) p-valueb) p-valuec)
IPSS, total 20.7±7.6 17.9±7.5 14.6±7.0 0.228 0.001 0.011
IPSS, voiding symptom 12.2±5.1 10.2±4.7 7.9±4.5 0.05 0.001 0.027
IPSS, storage symptom 8.3±3.5 7.7±3.5 6.3±3.4 0.258 0.011 0.011
IPSS, quality of life 4.6±1.1 4.3±1.2 3.6±1.1 0.367 0.001 0.024
Qmax (ml/sec) 10.6±2.6 12.3±5.6 12.1±4.5      
PVR (ml) 41.3±44.1 41.5±36.4 46.8±31.8      

Values are presented as mean±standard deviation.

Qmax: maximum urinary flow rate, PVR: post-void residual volume.

p-value compared baseline to the first month.

p-value compared baseline to the second month.

p-value compared first month to the second month.

Changes in the International Prostate Symptom Score (IPSS) of the control group (group 2)

  Baseline First month Second month p-valuea) p-valueb) p-valuec)
IPSS, total 19.3±5.4 15.2±7.7 10.6±6.2 0.009 0.001 0.004
IPSS, voiding symptom 11.7±4.3 9.3±5.3 5.9±4.3 0.006 0.001 0.003
IPSS, storage symptom 7.6±3.2 5.9±3.0 4.7±2.5 0.039 0.002 0.025
IPSS, quality of life 4.3±1.1 3.4±1.3 2.6±1.0 0.002 0.002 0.006
Qmax (ml/sec) 11.1±5.5 14.4±7.0 14.3±5.1      
PVR (ml) 63.6±55.1 56.1±53.4 40.1±35.6      

Values are presented as mean±standard deviation.

Qmax: maximum urinary flow rate, PVR: post-void residual volume.

p-value compared baseline to the first month.

p-value compared baseline to the second month.

p-value compared first month to the second month.