Review: Benign Prostatic Hypertrophy
Finasteride reduced symptoms and need for surgery for benign prostatic hypertrophy. Commentator, Barry, M. Massachusetts General Hospital, Boston, MA, USA.
Evidence-based Medicine, 3(4): 107, July/Aug. 1998.
The following article is briefly presented
The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. McConnel, J., Bruskewitz, R., Walsh, P. et al.
N Engl J Med, 338: 557-563, 26 Feb. 1998.
This was a 4-year randomized double-blind placebo-controlled trial involving around 3000 men who had BPH with moderate to severe lower urinary tract symptoms, decreased maximal urine flow rates and an enlarged prostate. They were randomized to receive either finasteride at 5 mg/day or placebo for 4 years.
The authors found the following:
• Those who had received finasteride had significantly greater decreases in symptom scores. Significantly fewer men in the finasteride group had surgery or acute urine retention.
•There was a significantly higher incidence of side effects in the finasteride group.
Commentary
The commentator suggests that patients should make an informed choice concerning treatment for BPH, as neither treatment option is particularly risky. The Veterans Affairs study (N Engl J Med, 1996) found terazosin to be superior to finasteride. A combination of ct-blocker and finasteride may work well for the long-term conservative management of BPH.
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