[Combination drug therapy in patients with BPH]

Area of Science:

• Urology
• Pharmacology

Background:

• Lower urinary tract symptoms (LUTS) are often caused by infravesical obstruction, primarily due to benign prostatic hyperplasia (BPH).
• BPH involves static, dynamic, and bladder functional components.
• Alpha-blockers address dynamic obstruction, while 5-alpha reductase inhibitors target the static component.

Purpose of the Study:

• To evaluate the efficacy of medical therapy modifications for BPH.
• To compare monotherapy with alpha-blockers, combination therapy, and a fixed-dose combination (Duodart).

Main Methods:

• 90 BPH patients were divided into three groups: monotherapy (alpha-blockers), combination therapy (5-reductase inhibitors + alpha-blockers), and Duodart.
• Treatment effectiveness was assessed via voiding diaries, I-PSS, QL questionnaires, uroflowmetry, and prostate ultrasonography.
• Adverse effects, treatment compliance, acute urinary retention (AUR), and surgical interventions were monitored over 12 months.

Main Results:

• Combination therapy significantly reduced LUTS and increased maximum flow rate (Qmax) compared to monotherapy.
• Groups II and III showed lower incidence of AUR and fewer surgical interventions, indicating disease progression prevention.
• Duodart demonstrated higher patient compliance and a reduced rate of AUR and surgical interventions compared to separate combination therapy.

Conclusions:

• Duodart effectively alleviates LUTS in BPH patients.
• This therapy reduces the risk of disease progression, including complications like AUR and the need for surgery.
• Improved management contributes to an enhanced quality of life for patients with BPH.