Retrospective Comparison of Transurethral Prostatic Columnar Water Balloon Dilation and Pharmacotherapy for...

This study aimed to compare the clinical efficacy, safety,and patient compliance of transurethral prostatic columnar water balloon dilation versus combination pharmacotherapy (α-blockers + 5α-reductase inhibitors) in patient with moderateto-severe benign prostatic hyperplasia (BPH).

This retrospective analysis included 120 patient with moderate-to-severe BPH (International Prostate Symptom Score[IPSS] 8-35 points, January 2022-December 2025) After propensity score matching (1:1), patient were divided into a surgical group (n = 60, transurethral prostatic columnar water balloon dilation) and a medication group (n = 60, combined pharmacotherapy). Key outcomes assessed at baseline and 1, 3, and 6 months post-treatment included IPSS, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), prostate volume (PV), quality of life (QoL), adverse events (AEs), compliance, and satisfaction.

At all follow-up points, both groups showed significant improvements in IPSS, QoL,PVR,and voiding time (p < 0.05). At 6 months, outcomes were significant better in the surgical group than in the medication group: total IPSS (8.32 ± 2.34 vs. 14.22 ± 2.57), Qmax (20.59 ± 3.51 vs. 14.54 ± 3.51 mL/s), and PVR (29.58 ± 9.67 vs. 45.92 ± 12.51 mL) (all p < 0.05). PV decreased significantly in the medication group (52.13 ± 8.56 vs.67.60 ± 10.12 mL, p < 0.05) but did not change significantly in the surgical group (p > 0.05). The surgical group had a lower unadjusted AE rate (6.7% vs. 20.0%, p = 0.032), but a higher standardized short-term procedural event rate. Complete compliance (95.0% vs. 68.3%, p < 0.001), and satisfaction (89.42 ± 6.83 vs. 73.62 ± 8.59, p < 0.001) were also higher in the surgical group.

For moderate-to-severe BPH, transurethral prostatic columnar water balloon dilation provides superior short-tomedium-term efficacy, safety, and compliance compared with pharmacotherapy, making it particularly suitable for high-risk or medication-intolerant patients.