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Dutasteride add‐on therapy reduces detrusor mass in patients with benign prostatic enlargement not satisfied with alpha‐adrenergic antagonist monotherapy: A single center prospective study
Author(s) -
De Nunzio Cosimo,
Brassetti Aldo,
Proietti Flavia,
Gacci Mauro,
Serni Sergio,
Esperto Francesco,
Tubaro Andrea
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23247
Subject(s) - medicine , dutasteride , lower urinary tract symptoms , urology , tamsulosin , bladder outlet obstruction , prostate , prospective cohort study , international prostate symptom score , benign prostatic hyperplasia (bph) , combination therapy , neck of urinary bladder , hyperplasia , urinary bladder , cancer
AIMS The ultrasound assessment of bladder wall thickness (BWT) and intravesical prostatic protrusion (IPP) have emerged as a non‐invasive, inexpensive, time‐saving alternatives to pressure‐flow studies to assess benign prostatic obstruction (BPO). Aim of our study was to evaluate the effect on detrusor mass of dutasteride add‐on therapy in men with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE). METHODS A consecutive series of BPE patients with a prostate volume (PV) ≥30 mL and an international prostate symptoms score (IPSS) ≥8 not satisfied with Tamsulosin monotherapy were enrolled. Free maximum flow (Qmax), PV, BWT, and IPP were recorded at baseline and at 24 weeks follow‐up. RESULTS Overall, 27 men were enrolled. Dutasteride significantly improved LUTS (−46.7%; P = 0.001) and Qmax (+18.7%; P = 0.001) and reduced PV (−13%; P = 0.002), BWT (−40.3%; P = 0.001), and IPP (−14.9%; P = 0.015). At baseline, based on BWT ≥5 mm and an IPP >10 mm, 13/27 (48%) and 15/27 (55%) patients were defined at risk for BPO, respectively; while after 24 weeks of treatment they were 3/27 (11.1%) and 11/27 (40%), respectively. CONCLUSIONS Dutasteride add‐on therapy significantly reduced IPP and detrusor mass and was effective in improving LUTS in patients with BPE not satisfied with αBs monotherapy. The possible role of BWT and IPP as proxies of medical treatment outcomes should be confirmed by further studies.