Peculiarities of the Course of Benign Prostatic Hyperplasia in Patients with Low Level of Prostate-Specific Antigen

INTRODUCTION: Benign prostatic hyperplasia (BPH) belongs to the most significant urologic diseases of older men. Most studies analyze the BPH manifestations in patients with prostate-specific antigen (PSA) > 4 ng/ml. Insufficient attention is given to the analysis of the clinical course of BPH with PSA level < 4 ng/ml. AIM: To analyze the peculiarities of the clinical course of BPH with PSA level < 4 ng/ml. MATERIALS AND METHODS: The study included 146 patients with BPH who underwent transurethral prostate resection in the urology department of Voronezh Regional Clinical Hospital No. 1 from 2020 to 2023. Patients were divided into 6 groups depending on PSA level and medication therapy. Patients of the first 3 groups received alpha1-adrenoblockers, patients of groups 4–6 received combination therapy with alpha1-adrenoblockers and 5α-reductase inhibitors. RESULTS: In patients of groups 2 and 3 who were on monotherapy with alpha1-adreno-blockers, the score on the international scale of prostatic symptoms (International Prostate Symptom Score, IPSS), was higher than in patients of groups 5 and 6, with combined treatment and amounted to 28.0 [23.0; 31.0] and 27.0 [23.0; 28.0], respectively, however, is statistically insignificant (p > 0.05). Acute urinary retention (OCM) was statistically significantly less frequently detected in groups 5 and 6, in 50% and 10% of cases, respectively, versus 89% (p = 0.002) and 58% (p = 0.001) of cases in groups 2 and 3 respectively. There were no statistically significant differences in the frequency of OCM in patients of groups 1 and 4. Among the concomitant diseases in patients with BPH, diseases of the cardiovascular system were more often detected. CONCLUSION: In the studied groups of BPH patients with a low PSA value, the score on the IPSS scale did not differ statistically significantly. OZM was more common in patients with BPH who were on monotherapy with alpha-1 adreno-blockers. Diseases of the cardiovascular system prevailed among concomitant diseases in patients with BPH.