Surgery more beneficial than drug therapy for benign prostatic hyperplasia

A 17-year-long community study looking at symptoms of enlarged prostate in over 2,000 men age 40 to 79 years suggests that surgery for benign prostatic hyperplasia (BPH) offers more relief from incontinence and obstruction symptoms than treatment from drug-based therapy, according to a new study by researchers at Mayo Clinic. The researchers presented their results today at the annual meeting of the American Urological Association.

Overall, results show:
•Urinary incontinence was a common condition, coexisting with BPH/lower urinary tract symptoms.
•In the community setting, patients with the highest symptom scores were most likely to receive surgical intervention.
•Symptoms stabilized and did not get worse after treatment of all kinds.
•Patients who underwent transurethral resection of the prostate (TURP) had the greatest decrease in both symptoms and incontinence compared to other treatment groups. Pre-TURP the incontinence rate was 64.5 percent and post-TURP it was 41.9 percent.

Significance
The findings provide large-sample, long-term data comparing the effectiveness of medical versus surgical treatments in a large, general population, as compared to small, select clinical populations of men. "Our data fills a gap in the research record that can be used by physicians and patients to evaluate management options," says Amy Krambeck, M.D., Mayo Clinic urologist and lead study investigator. "Because it's a large community-based study of more than 2,100 men, it includes the entire broad range of male health. This suggests the results are stronger in terms of being generalized and applied to other men."