THE RESULTS OF TREATMENT OF BENIGN PROSTATIC OBSTRUCTION WITH FINASTERIDE
Abstract
Background. Finasteride is an inhibitor of 5 alpha-
reductase. It prevents the conversion of testosterone into
dihydrotestosterone, which results in gradual decrease in prostatic
volume. The objective of the study was to determine the
impact of finasteride on subjective and objective symptomatic
improvement in patients with benign prostatic obstruction
(BPO).
Patients and methods. This open prospective multicenter study
of 6-month duration included 370 men, mean age 63 years
(range; 45–75 yrs), with clinical manifestations of BPO. The
enrolled patients received finasteride 5 mg/day. On the completion
of therapy, the patients were assessed for symptomatic
improvement, urinary flow and prostatic volume, determined
by rectal examination and ultrasound. Total prostate-specific
antigen levels in the serum were measured. At the end of the
study, the patients were asked to evaluate the efficacy of finasteride
therapy and to report its possible adverse side-effects.
Statistical analysis of the results was done using the Student ttest.
Results. Of the 370 patients enrolled, 303 (82%) completed the
6-month study period. The rate of urinary symptoms declined
by an average of 55%, of which nocturia by 28% and difficulty
in initiating the urinary stream by 74%. There was a
statistically significant decrease in prostatic volume on rectal
examination (14%; p < 0.0001) and abdominal ultrasound
(16%; p < 0.0037). The difference between both measurements
was statistically significant (p = 0.0037). Finasteride produced
a statistically significant improvement in maximum urinary
flow rate and voiding time (p < 0.0001 and p = 0.0017,
respectively). Untoward side-effects were experienced by 3.5%
of the patients who had completed the 6-month period of finasteride
therapy. A the end of the study, 65% of the patients
reported notable improvement in micturition, and 76% stated
they would continue taking finasteride.
Conclusion. Placing patients with urinary symptoms due to
BPO on a 6-month course of finasteride has proved safe and
effective.
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