A Propensity Score-Matched Protocol: Terazosin Plus Finasteride For Benign Prostatic Hyperplasia - Sex Hormone And Urinary Control Effects

To investigate the clinical effect of terazosin hydrochloride combined with finasteride in benign prostatic hyperplasia (BPH), and to analyze its effect on sex hormones and urinary control. This retrospective propensity score‑matched (PSM) cohort study included BPH patients treated between January 2020 and March 2021. 1:1 PSM using logistic regression with prespecified covariates (age, BMI, IPSS, Qmax, PVR, PV, PSA, CRP, T, E2, DHT, incontinence episodes, ICIQ‑SF); inclusion criteria (age 50‑80 years, IPSS ≥ 8, PSA > 1.4 ng/mL, PV ≥ 40 mL, Qmax ≤ 15 mL/s); exclusion of prior prostate surgery or 5α‑reductase/α1‑blocker use; 12‑month treatment and 36 month follow up with outcomes measured at 6, 12, 24, 36 months. Sixty patients were allocated to each group after PSM. The combination group showed significantly greater improvements in IPSS, Qmax, PVR, and PV (all P < 0.05), lower DHT and E2, higher T (all P < 0.05), fewer 24 h incontinence episodes, and better ICIQ‑SF scores (both P < 0.05). Safety profiles were comparable (P > 0.05). The terazosin‑- finasteride regimen is associated with improved long-term outcomes, better urinary control, and favorable hormonal changes, though hormonal effects are primarily attributable to finasteride.