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Purpose: To investigate the effect of metabolic syndrome (MetS) on the response to medicaltherapy of benign prostatic hyperplasia (BPH) after a 3-month period of treatment. Materials and Methods: This was a cohort study of 100 patients, 47 with MetS and 53without MetS, referred to either the primary care unit or referral hospital with BPHwho had moderate lower urinary tract symptoms of prostate involvement and were candidatesfor medical treatment. Our main outcome was response to medical treatmentwith prazosin 1 mg twice a day and finasteride 5 mg daily in patients with BPH on thebasis of International Prostate Symptom Score (IPSS). Multivariate analysis of covariancewas used to compare BPH treatment response in patients with and withoutMetS before and after receiving treatment. Results: The mean volume of the prostate was significantly higher in MetS patientsthan in patients without MetS (57±32.65 mL compared with 46.00±20.19 mL, p=0.036). The control group demonstrated an 11-unit reduction in IPSS, whereas those with MetSshowed a reduction in the symptom score of only 6 units (p<0.001). Regarding the componentsof MetS separately, triglyceride (p<0.001), fasting blood sugar (p=0.001), andwaist circumference (p=0.028) significantly affected the clinical progression of BPH. The observational nature of this study may be a limitation in comparison with an interventionalstudy. Conclusions: The results of the present study showed that MetS can negatively affectthe response to medical treatment of BPH. Therefore, it is necessary to consider MetSin selecting patients with BPH for drug therapy.

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