Continued improvement in pressure-flow parameters in men receiving finasteride for 2 years. Finasteride Urodynamics...

Area of Science:

• Urology
• Pharmacology
• Medical Science

Background:

• Benign prostatic enlargement (BPE) commonly causes lower urinary tract symptoms (LUTS) and bladder outflow obstruction (BOO).
• Urodynamic assessment, specifically pressure-flow studies (PFS), is crucial for diagnosing and evaluating BOO severity.
• Long-term treatment effects of finasteride on objective BOO measures require further investigation.

Purpose of the Study:

• To evaluate the long-term efficacy of finasteride in improving pressure-flow parameters in men with documented BOO.
• To assess the sustained effects of finasteride treatment over a 24-month period.

Main Methods:

• A randomized, placebo-controlled trial involving 121 men with BPE and LUTS.
• Patients underwent standardized pressure-flow studies (PFS) to document bladder outflow obstruction (BOO).
• Obstructed patients were randomized to finasteride (5 mg) or placebo for 12 months, followed by an open-label finasteride extension for up to 24 months.

Main Results:

• Finasteride significantly decreased detrusor pressure at maximum flow (PdetQmax) over 24 months (11.7 cm H2O decrease).
• The proportion of obstructed patients, based on the Abrams-Griffiths nomogram, decreased from 76.2% at baseline to 59.6% at 24 months.
• Continued improvement in urodynamic measures was observed during the second year of finasteride therapy.

Conclusions:

• Finasteride effectively improves urodynamic measures of bladder outflow obstruction (BOO) in men with benign prostatic enlargement (BPE).
• The beneficial effects of finasteride on BOO parameters are sustained and continue to improve during the second year of treatment.
• Finasteride represents a viable long-term therapeutic option for managing BOO in men with BPE.