In a nutshell
This study examined factors that affect treatment outcomes with dutasteride (Avodart) for benign prostatic hyperplasia (BPH). Researchers reported that the amount that the prostate protruded into the bladder before treatment was the strongest predictor of treatment success.
Some background
An enlarged prostate can protrude into the bladder and urinary tract, causing bothersome urinary symptoms. Drugs that are commonly prescribed for treating urinary symptoms in BPH include 5-alpha reductase inhibitors such as dutasteride. 5-alpha reductase inhibitors work by affecting levels of male hormones in the prostate. This is believed to reduce the size of the prostate and increase the flow of urine. Identifying predictors of treatment success is important in helping to select patients that are likely to benefit from dutasteride.
Methods & findings
The aim of this study was to find predictors of treatment outcomes of dutasteride in men with BPH.
120 men with moderate-to-severe urinary symptoms due to BPH were included. All men were treated with dutasteride for 12 months. Questionnaires and physical examinations were administered before and after treatment.
Average prostate size before treatment was 58.9 ml. This decreased significantly (to 41.6 ml) after 12 months of dutasteride treatment. Physical examinations also showed improvements in bladder capacity, urine flow, and bladder overactivity. However, the amount of prostate protrusion into the bladder did not decrease significantly. It was 13.4 mm before treatment and 12.9 mm after treatment.
Overall, men reported significantly improved urinary symptoms at 12 months. 39.4% of men showed very good improvements in BPH-related urinary symptoms. 29.8% showed a fair improvement and 30.8% showed insufficient improvement. The degree of protusion of the prostate into the bladder at baseline was the strongest predictor of treatment success. Men with a protrusion over 13 mm before treatment were significantly less likely to respond to dutasteride.
6.7% of men had discontinued treatment at 12 months. The reasons included reactions to treatment such as breast disorder, a reduced sex drive, and ejaculation disorder.
The bottom line
Researchers concluded that prostate protrusion can predict outcomes with dutasteride treatment.
The fine print
Larger studies comparing dutasteride to placebo (control drug with no active effect) or other treatments are needed to validate these results.
Published By :
Neurourology and urodynamics
Date :
Jan 19, 2017
