[The effect of 5-alpha-reductase inhibitors on benign prostatic hyperplasia].

Abstract

The prevalence of BPH is high in elderly men with more than 60% of patients over the age of 60 experiencing some form of prostatism. Balancing the superior benefit of TUR/P are the small but significant risks and complications of surgery and the high cost of the procedure. The WHO guidelines recommend finasteride or alpha-blockers as treatment options for men with bothersome symptoms. Finasteride therapy reduces the volume of the hyperplastic prostate gland by more than 20%, improves the urinary flow rate and the symptoms associated with bladder outlet obstruction. Although statistically significant, results obtained with finasteride are just slightly better than placebo and TUR/P still offers the greatest improvement of symptoms. Finasteride is well tolerated and adverse events are rare. However, it decreases serum PSA (prostate specific antigen) by 50%, suggesting careful monitoring and exclusion of prostate cancer before initiation and during therapy. Current research is focusing on developing new 5-alpha-reductase inhibitors (type I and II) using polyunsaturated fatty acids and nonsteroidal inhibitors. Given the multifactorial nature of BPH, further clinical trials combining 5-alpha-reductors inhibitors and 5-alpha-receptor blockers are still needed.

• Authors: B Djavan, J McConnell
• Journal: Wiener medizinische Wochenschrift (1946) (Wien Med Wochenschr) Vol. 146 Issue 8 Pg. 165-8 ( 1996) ISSN: 0043-5341 [Print] Austria
• Vernacular Title: Der Einfluss der 5-alpha-Reduktase-Inhibitoren auf die benigne Prostatahyperplasie.
• PMID: 8767401 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• 5-alpha Reductase Inhibitors
• Enzyme Inhibitors
• Finasteride

Topics

• 5-alpha Reductase Inhibitors
• Aged
• Enzyme Inhibitors (adverse effects, therapeutic use)
• Finasteride (adverse effects, therapeutic use)
• Humans
• Male
• Prostatic Hyperplasia (drug therapy, etiology)
• Randomized Controlled Trials as Topic
• Treatment Outcome