We aimed to investigate the difference in efficacy of medical treatment of symptomatic benign prostatic hyperplasia (BPH) between normal and obese patients with BPH; obesity was determined by either body mass index (BMI) or waist circumference (WC). In this 12-week prospective observational study, a total of 175 patients aged ≥40 years with International Prostate Symptom Scores (IPSS) ≥12 points and prostate volume ≥20ml were prospectively enrolled. The patients were divided into two groups according to BMI or WC. Patients received the doxazosin gastrointestinal therapeutic system (GITS) at a dose of 4mg once per day for 12 weeks. The changes from baseline in the IPSS, maximal urinary flow rate (Q max), post-void residual volume, quality of life (QoL) scores and adverse events (AEs) were analysed. Of the 175 enrolled patients, 132 completed the study. Sixty-seven patients had BMI 23kg m -2, and 43 had WC >90cm. Obese patients represented by WC >90cm or BMI ≥23kg m -2 had a significantly greater prostate volume compared with non-obese patients at baseline. Total IPSS was significantly higher in the WC >90cm group compared to the WC 90cm group. Total IPSS was positively correlated with prostate volume (P=0.031) and WC (P=0.045). All groups showed significant improvements in total IPSS and QoL at 12 weeks. However, the improvement of total IPSS was greater in the high-BMI and high-WC groups. The most frequent AE was dizziness (n=13), and it was significantly lower in the obese BPH patients. Obesity was associated with increased prostate volume and lower urinary tract symptoms. Alpha-blockers appear to be efficacious for controlling symptoms, especially in obese men.
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