Efficacy of Adding Dutasteride to α‐Blocker Therapy Treated Benign Prostatic Hyperplasia Patients with Small Volume Prostate (<30 mL )

Objectives To assess the efficacy of dutasteride add‐on therapy for patients with benign prostatic hyperplasia ( BPH ) and lower urinary tract symptoms ( LUTS ) with small prostates who have been treated with α‐blocker therapy for >3 months. Methods A total of 110 men with clinical BPH were enrolled. There were 17 and 93 subjects with a prostate volume ( PV ) <30 and ≥30 mL , respectively. All subjects had been treated with α‐blocker therapy for >3 months. Subjective and objective clinical variables were assessed using the total International Prostate Symptom Score ( IPSS‐T ), IPSS quality of life ( IPSS‐QoL ), IPSS voiding subscore ( IPSS‐V ), IPSS storage subscore ( IPSS‐S ), overactive bladder symptom score ( OABSS ), PV , prostate specific antigen ( PSA ) level, post‐void residual ( PVR ), and maximum flow rate ( Qmax ). These variables were assessed at baseline and every 3 months for 1 year. Results In the small prostate group, IPSS‐T and IPSS‐V showed improvements from baseline at 6 and 9 months, storage subscore at 6 months, and OABSS at 3 months, but no sustained improvements were observed. During the study period, only the IPSS QoL scores did not show any improvement. Conversly, dutasteride was significantly effective at improving IPSS‐T , IPSS‐V , IPSS‐S , and IPSS‐QoL scores throughout the study period in the large prostate BPH group. PSA levels and PV significantly decreased in both groups throughout the study. Conclusions Benign prostatic hyperplasia in LUTS patients with small prostates did not show a sustainable benefit from the addition of dutasteride to α‐blocker therapy.