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Related Experiment Videos

Long-term effects of finasteride on prostate tissue composition.

L S Marks1, A W Partin, F J Dorey

  • 1Department of Urology, University of California, Los Angeles School of Medicine, USA.

Urology
|March 30, 1999
PubMed
Summary

Long-term finasteride treatment significantly reduces prostate epithelium volume, continuing to progress over months. This effect is consistent across prostate zones, suggesting epithelial contraction is key to sustained BPH symptom relief.

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Area of Science:

  • Urology
  • Pharmacology
  • Medical Imaging

Background:

  • Benign prostatic hyperplasia (BPH) is a common condition in aging men.
  • Finasteride is a 5α-reductase inhibitor used to treat BPH.
  • The long-term effects of finasteride on prostate tissue composition and its mechanism of action require further elucidation.

Purpose of the Study:

  • To investigate the long-term impact of finasteride on prostate tissue composition.
  • To correlate these tissue changes with clinical outcomes in BPH patients.
  • To determine if finasteride has a selective effect on the prostate's transition zone.

Main Methods:

  • A 24-month open-label extension study involving 19 men with BPH who responded to 6-month finasteride treatment.
  • Serial magnetic resonance imaging (MRI) and prostate biopsies for morphometric analysis were conducted.

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  • Measurements included prostate volume, transition zone proportion, and epithelial/stromal composition over time.

    • Main Results:

    • Finasteride treatment led to sustained decreases in BPH symptoms, dihydrotestosterone, prostate-specific antigen, and prostate volume.
    • Prostate epithelium volume progressively contracted from 19.2% at baseline to 6.4% after long-term treatment (24-30 months).
    • Epithelial contraction occurred similarly in peripheral and transition zones, with the transition zone maintaining its relative proportion of whole prostate volume.

    Conclusions:

    • Long-term finasteride treatment induces significant and progressive involution of prostate epithelium.
    • The mechanism for sustained finasteride action in BPH appears to be the progressive contraction of prostate epithelium.
    • Finasteride's effects on prostate epithelium are not selective for the transition zone, impacting both peripheral and transition zones similarly.