Between January and July 2007, 40 consecutive BPH patients
with LUTS, whose age ≥50, seen in the urology outpatient
clinic, included in this prospective study. Patients with a
history of prostatic malignancy, surgery of the prostate, bladder
neck or urethral stricture, who received previous treatments
for LUTS and those with neurologic diseases affecting
the lower urinary tract, excluded from the study. Before the
treatment all patients were evaluated in details including past
medical history, IPSS, physical examination, digital rectal
examination, complete blood count, blood biochemistry,
urine analysis, prostate specific antigen (PSA) and uroflowmetry.
Serum PSA levels were measured by using monoclonal
Tandem-R assay (Hybritech Inc., San Diego, CA,
USA). All patients fully informed about the medical
treatment and consent forms were provided.
Prostatic RI was measured using PDI by single radiologist
(TD). Ultrasound examination consisted of transrectal
ultrasonography (TRUS) and PDI using an SSA 380A unit
(Toshiba Corp., Japan) with a convex, 7-MHz transrectal
probe. Each patient was asked to empty his urinary bladder to preclude compression of the intraprostatic vasculature. At the
area of greatest transverse diameter in the axial plane, the
antero-posterior and transverse dimensions of prostate were
measured and recorded. Blood flow measurements were
obtained from capsular arteries on the largest transverse
section of prostate, followed by spectral waveform analysis.
When pulsatile waveforms of a given Doppler spectrum
became stable, RI (maximum velocity-minimum velocity/
maximum velocity) was measured from each blood flow
sample using on-board software and the mean value was
recorded. During the whole ultrasonographic study, care was
taken to avoid excess probe pressure on the rectal wall.
After the PDI measurements, 8mg/day Doxazosin were
administered starting from 2mg/day and titrating the dose
every 2 weeks to 4mg and finally 8mg/day, and was continued
for 6 months. After the treatment all patients were reevaluated
with PDI, IPSS and uroflowmetry.
All statistical analyses were performed by using Statistical
Packet for Social Science (SPSS) software, version 11.5
(SPSS Inc., Chicago, USA). Descriptive statistics were presented
as mean±standard deviation (SD). Statistical analyses
were performed by using the Spearmen’s Correlation Coefficient
and Wilcoxon Sign Rank test. When p values <0.05
considered as statistically significant.
)