Efficacy and Safety of Add-on Treatment with Mirabegron for Benign Prostatic Hyperplasia Patients with Persistent Storage Symptoms after Alpha‌- blocker therapy.

Introduction: Benign prostatic hyperplasia (BPH) is the most common benign disease in men with various lower urinary tract symptoms (LUTS. Clinically BPH results in LUTS , which can be classified as storage, voiding, and post micturition, and often affect patients' quality of life (QoL) Aim of the study: The study aims to evaluate the effect of adding mirabegron for benign prostatic hyperplasia patients complaining of persistent storage symptoms after alpha-blocker therapy.Subjects and Methods: Our prospective study included 50 male patients with persistant storage LUTS , after they were managed by a regular daily dose of α1-adrenergic receptor blockers for 4 weeks .We added mirabegron 50 mg once daily for 8 weeks .Results: Fifty men were enrolled in this study. Mirabegron additional therapy improved the total OABSS from 8.66± 2.28 to 5.12 ± 1.85 , total IPSS from 17.98 ± 2.9 to 10.88 ±2.69 , and IPSS-quality of life (QOL) score from 5 (4- 5) to 2 (2- 3) . The voided volume (VV) and Qmax improved from 10.90 (9.60-12.13) mL/s to 14.00 (12.48-15.05) mL/s after treatment in patients overall. However, there was no significant change in PVR.Conclusions: Mirabegron additional therapy is effective and safe for treatment of persistant storage symptoms after alpha blocker medication. , Therefore, we recommend the combination therapy of AB and mirabegron as a first-line therapy for patients with BPH who have persistent storage symptomsKeywords : Mirabegron, Elderly male, Overactive bladder, α1-adrenergic blockers