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Increased prostate size are at higher risk of incident lower urinary tract symptoms presumed due to benign prostatic hyperplasia


It has been shown that increased prostate size is a risk factor for lower urinary tract symptom ( LUTS ) progression in men who currently have LUTS presumed due to benign prostatic hyperplasia ( BPH ).

The study aim was to determine if prostate size is a risk factor for incident lower urinary tract symptom in men with mild to no symptoms.

Researchers have conducted a post hoc analysis of the REDUCE study, which contained a substantial number of men ( n=3090 ) with mild to no LUTS ( International Prostate Symptom Score [ IPSS ] less than 8 ).

The primary outcome was determination of the effect of prostate size on incident LUTS presumed due to benign prostatic hyperplasia defined as two consecutive IPSS values more than 14, or receiving any medical ( alpha-blockers ) or surgical treatment for benign prostatic hyperplasia throughout the study course.

Among men treated with placebo during the REDUCE study, those with a prostate size of 40.1-80 ml had a 67% higher risk ( hazard risk, HR=1.67, 95% confidence interval 1.23-2.26, p=0.001 ) of developing incident LUTS compared to men with a prostate size 40.0 ml or smaller.

There was no association between prostate size and risk of incident LUTS in men treated with 0.5 mg of Dutasteride.

The post hoc nature of the study design is a potential limitation.

In conclusion, men with mild to no lower urinary tract symptom but increased prostate size are at higher risk of incident LUTS presumed due to benign prostatic hyperplasia.
This association was negated by Dutasteride treatment. ( Xagena )

Simon RM et al, Eur Urol 2015; Epub ahead of print

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