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Purpose: Many benign prostatic hyperplasia (BPH) patients were accompanied by pelvic pain apart from urinary symptoms. Therefore, we evaluate the treatment outcomes of alpha-blockers via a change of international prostate symptom score (IPSS) according to pain score of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI).Materials and Methods: A total of 356 male patients with BPH from March 2011 to May 2014 were analyzed retrospectively. Prostate specific antigen, prostate volume, IPSS, NIH-CPSI, international index of erectile function (IIEF-5), and uroflowmetry were collected. Patients were categorized according to 2 groups based on the presence and severity of pain and baseline characteristics and treatment outcomes were analyzed.Results: Two hundred twenty-nine patients (64.3%) reported pain/discomfort on NIH-CPSI. Mean IPSS, mean voiding symptoms, mean storage symptoms on IPSS, and mean IIEF-5 showed a significant difference in groups 1A and 1B. Logistic regression analysis showed that NIH-CPSI pain score was a significant predictive factor for severe IPSS (odds ratio, 2.830; 95% confidence interval, 1.307-6.129). After treatment for 3 months, improvement of IPSS, voiding symptoms, storage symptoms, and quality of life was observed in all groups (p=0.001, p<0.001, p=0.026, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001). Group 2B (pain score>5) showed greater improvement of symptoms and statistically significant difference compared with group 2A (pain score ≤5) (p=0.029, p=0.026).Conclusions: We suggest that the presence and severity of pain score are helpful for therapeutic efficacy in patients with BPH.

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