Adherence to Medical Therapy in Benign Enlargement of Prostate (BEP) Patients at Teaching Hospital

Abstract

Background:

Lower urinary tract symptoms (LUTS) secondary to benign enlargement of the prostate (BEP) are among the most common urological problems affecting aging men. Medical therapy, often involving single or multiple drug regimens, is the mainstay of initial management. However, adherence to long-term pharmacotherapy remains a significant challenge.

Methods:

A prospective cross-sectional study was conducted in the Department of Urology at KIST Medical College Teaching Hospital from December 25, 2025 to March 15, 2026. Patients diagnosed with BEP and receiving medical therapy were recruited. Data were analyzed using logistic regression, along with univariate and multivariate analyses to identify factors associated with adherence.

Results:

The mean age of patients was 57.5 ± 8.5 years, with the highest proportion in the 61–70 years age group (36.3%). Alpha-blockers were the most commonly prescribed medications (100%), followed by 5-alpha reductase inhibitors (45.23%). Other medications included anticholinergics, beta-3 agonists, and phosphodiesterase inhibitors. The most common side effect observed was retrograde ejaculation (53.5%), followed by decreased libido (17.4%) and weakness with giddiness (16.4%). The main reasons for non-adherence were high cost of medication (11.52%), side effects (9.88%), and prolonged duration of therapy (6.82%). Approximately 20.3% % of patients crossed over to surgical management during the study period.

Conclusion:

Adherence to medical therapy was higher in patients receiving monotherapy and lower in those on multiple medications. Adherence declined over time, particularly with prolonged treatment duration. Financial burden and drug-related side effects were major contributors to non-adherence.