전립선비대증환자에서 전립선의 조직유형에 따른 Alpha1-수용체차단제의 치료효과

Abstract

Purpose: Benign prostatic hyperplasia(BPH) describes a hyperplastic process of the stromal and epithelial elements of the prostate. The proliferative rates of each compartment in BPH may vary individually and the prostate is topographically not affected in a uniform way. The proposed mechanism of alpha1-blockers in the treatment of BPH is the decrease of prostatic urethral resistance by relaxing the prostatic smooth muscle component present in the stroma. The purpose of this study is to search the effect of alpha1-blockers according to histologic compositions in patients with BPH. Materials and Methods: From January 1994 to June 1997, 74 patients were treated with alpha1-blockers(>1month) before prostatectomy. Of 74 patients, the international prostate symptom score(IPSS) was used in 62 patients to evaluate the severity of voiding difficulties. The clinical response to alpha1-blockers was based upon change in IPSS during medication period. According to histological compositions of prostatectomy specimen, the patients were classified into three groups: predominantly stromal type(20 patients), predominantly glandular type(21 patients) and mixed type(21 patients). Results: There were 17 patients in response group and 45 patients in nonresponse group. The stromal type, glandular type and mixed type were composed of 52.9%, 17.7% and 29.4% respectively in response group and 24.4%, 40.1% and 35.5% respectively in nonresponse group. There was no statistical significant differences between clinical response of the alpha1-blockers and histologic compositions in patients with BPH(p>0.05). Conclusions: Although stromal type was predominant in response group and glandular type was predominant in nonresponse group, the relationship between the effects of alpha1-blockers and histologic compositions in patients with BPH was not statistically significant. Further evaluation will be necessary to assess the association between effects of alpha1-blockers and histologic difference of prostate in patients with BPH. Key word : Benign prostatic hyperplasia, Alpha1-blockers, Epithelium