PMID- 36129917
OWN - NLM
STAT- MEDLINE
DCOM- 20220923
LR  - 20220928
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 17
IP  - 9
DP  - 2022
TI  - Predictive factors for alpha blocker use after transurethral prostatectomy: Can 
      preoperative urodynamic outcome predict alpha blocker medication after surgery?
PG  - e0274399
LID - 10.1371/journal.pone.0274399 [doi]
LID - e0274399
AB  - OBJECTIVE: To analyze the diagnostic value of conducting urodynamic study (UDS) 
      and show predictors for alpha blocker use 12 months after transurethral 
      prostatectomy. MATERIALS AND METHODS: Our study includes 406 participants that 
      had a transurethral prostatectomy at our hospital between 2010 and 2019. All 
      participants took alpha blockers for more than a month. We collected the 
      participants' preoperative international prostatic symptom score (IPSS), 
      uroflowmetry, transrectal ultrasound, and serum prostatic antigen (PSA) level. A 
      total of 254 patients conducted UDS. After surgery, participants visited our 
      hospital at 1,3,6, and 12 months. RESULTS: 133 patients (32.6%) took alpha 
      blockers continuously for 12 months after surgery. They reported poor 
      preoperative IPSS scores and uroflowmetry outcomes. They also had high 
      postoperative PVR (40.68+/-24.56 vs 29.34+/-25.11, p<0.001) and total IPSS score 
      (10.35+/-7.96 vs 8.43+/-6.74, p = 0.018) compared to the group which discontinued 
      alpha blockers. A multivariate analysis (Table 2) found that conducting 
      preoperative UDS (Odds ratio (OR) 6.067, p<0.001) Age>75 (OR 2.463, p<0.001), a 
      history of taking 5-alpha reductase inhibitors (5-ARI) before surgery (OR 2.186 
      [95% CI 1.334-3.583], p = 0.002), IPSS item straining (OR 1.224, p = 0.003), 
      duration of taking alpha blockers [OR 1.009, p = 0.020), and Qmax (OR 0.926, p = 
      0.018), PVR (OR 1.002, p = 0.022) were confirmed as a strong predictors of 
      persistent alpha blocker use. CONCLUSION: Conducting preoperative UDS, Age>75, 
      history of taking 5-ARI before surgery, IPSS item straining, duration of alpha 
      blocker medication, Qmax, and PVR are possible determinant factors of alpha 
      blocker use after surgery. By comparing UDS outcomes, detrusor underactivity can 
      be a strong predictor of persisting alpha blocker therapy 12 months after 
      surgery.
FAU - Kim, Sung Jin
AU  - Kim SJ
AUID- ORCID: 0000-0002-0183-5689
AD  - Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym 
      University College of Medicine, Seoul, South Korea.
FAU - Park, Sung Gon
AU  - Park SG
AD  - Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym 
      University College of Medicine, Seoul, South Korea.
FAU - Pak, Sahyun
AU  - Pak S
AD  - Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym 
      University College of Medicine, Seoul, South Korea.
FAU - Lee, Young Goo
AU  - Lee YG
AD  - Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym 
      University College of Medicine, Seoul, South Korea.
FAU - Cho, Sung Tae
AU  - Cho ST
AUID- ORCID: 0000-0002-4691-6159
AD  - Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym 
      University College of Medicine, Seoul, South Korea.
FAU - Kwon, Ohseong
AU  - Kwon O
AUID- ORCID: 0000-0002-8933-6656
AD  - Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym 
      University College of Medicine, Seoul, South Korea.
LA  - eng
PT  - Journal Article
DEP - 20220921
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (5-alpha Reductase Inhibitors)
RN  - 0 (Adrenergic alpha-Antagonists)
SB  - IM
MH  - 5-alpha Reductase Inhibitors/therapeutic use
MH  - Adrenergic alpha-Antagonists/therapeutic use
MH  - Aged
MH  - Humans
MH  - Male
MH  - *Prostatic Hyperplasia/surgery
MH  - *Transurethral Resection of Prostate
MH  - Treatment Outcome
MH  - Urodynamics
PMC - PMC9491595
COIS- There are no conflicts of interest to declare.
EDAT- 2022/09/22 06:00
MHDA- 2022/09/24 06:00
PMCR- 2022/09/21
CRDT- 2022/09/21 13:43
PHST- 2022/05/02 00:00 [received]
PHST- 2022/08/26 00:00 [accepted]
PHST- 2022/09/21 13:43 [entrez]
PHST- 2022/09/22 06:00 [pubmed]
PHST- 2022/09/24 06:00 [medline]
PHST- 2022/09/21 00:00 [pmc-release]
AID - PONE-D-22-12644 [pii]
AID - 10.1371/journal.pone.0274399 [doi]
PST - epublish
SO  - PLoS One. 2022 Sep 21;17(9):e0274399. doi: 10.1371/journal.pone.0274399. 
      eCollection 2022.