การเปรียบเทียบอัตราการทำผ่าตัดต่อมลูกหมากในผู้ป่วยต่อมลูกหมากโตที่ได้รับ α-blockers เพียงอย่างเดียวเทียบกับผู้ป่วยที่ได้รับยา α-blockers และ 5-alpha reductase inhibitor ในโรงพยาบาลอ่างทอง
Keywords:
BPH, Alpha-blocker, 5-alpha reductase inhibitor, TURP, PSAAbstract
5-alpha reductase inhibitors (5ARIs) reduce prostate volume and prostate-specific antigen (PSA) levels. This retrospective study at Ang Thong Hospital, where many patients are managed by general surgeons due to the shortage of full-time urologists, aimed to compare outcomes between alpha-blocker monotherapy and combination therapy. Data from 571 patients treated between January 1st, 2020, and October 31st, 2025, were analyzed. Statistical methods included the Chi-square test, ANOVA, multivariable logistic regression, and Pearson correlation to evaluate prostate volume, PSA levels, and rates of transurethral resection of the prostate (TURP).
Older patients and patients with larger prostate volumes were significantly more likely to receive combination therapy compared with younger patients and those with smaller prostate volumes (mean age 72 vs. 68 years; mean prostate volume 50 vs. 39 g; both p < 0.001). However, TURP rates did not differ significantly between the two groups (p = 0.691; OR = 0.897, 95% CI 0.525–1.532). Increasing age showed a weak association with prostate volume (r = 0.346, p < 0.001) and PSA level (r = 0.328, p < 0.001), while PSA level had a moderate correlation with prostate volume (r = 0.676, p < 0.001). Factors significantly associated with undergoing TURP included age, prostate volume, PSA level, PSAD, and a history of hypertension. Diabetes mellitus, hyperlipidemia, and the type of medication used were not significantly associated with the needs for surgery.
In conclusion, in hospitals where benign prostatic hyperplasia is mainly treated by general surgeons due to limited urologic specialists, older patients and those with larger prostates were more likely to receive combination therapy. However, TURP rates were similar to those of patients treated with alpha-blocker alone.
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