Urology>>>>>Benign Prostatic Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS)
Question 7#

With reference to the MTOPS trial, which of the following is TRUE?

A. Single centre randomised double blinded controlled trial
B. Had the following four arms: placebo, tamsulosin, finasteride and combination
C. Defined an IPSS score increase in 4 or more as a secondary outcome
D. Defined stress incontinence as a primary outcome
E. Revealed a relative risk reduction in acute urinary retention of 81% in the combination arm compared with placebo

Correct Answer is E


Answer E

This study was a long-term, multi-centre double-blind trial (mean follow-up, 4.5 years) involving 3047 men to compare the effects of placebo, doxazosin, finasteride and combination therapy on measures of the clinical progression of benign prostatic hyperplasia. The risk of overall clinical progression (primary end points) – defined as an increase above base line of at least four points in the American Urological Association symptom score, acute urinary retention, urinary incontinence, renal insufficiency or recurrent urinary tract infection – was significantly reduced by doxazosin (39% reduction and finasteride (34%), as compared with placebo. The reduction in risk associated with combination therapy (66% for the comparison with placebo) was significantly greater than that associated with doxazosin or finasteride therapy alone. The risks of acute urinary retention and the need for invasive therapy were significantly reduced by combination therapy and finasteride but not by doxazosin (McConnell et al., 2003).