The efficacy of finasteride in the treatment of symptomatic benign prostatic hyperplasia

Benign prostatic hyperplasia is a common disease in aged men; the standard therapy has surgery. However, candidates for prostatectomy are commonly aged with high surgical risks, for whom medical treatment is preferable choice.

From February 1994 to April 1994, in total 25 men with symptomatic benign prostatic hyperplasia were enrolled into this prospective study. All patients were treated with finasteride 5 mg per day for six months.

Seven patients withdrew from the study, one for exasperated symptoms, three for personal reasons and three patients were excluded because of poor compliance. In total 18 patients completed the six-month therapy and surveillance. The AUA symptom scores improved on average by 6.3 points; prostatic adenoma volume reduced from baseline by 17%, and the serum prostate specific antigen (PSA) level decreased by 35%. No improvement of the rate of urinary flow was noted. Sixty-one per cent of patients had more than 50% improvement in subjective symptom scores, 28 per cent of men showed per cent or greater decrease in prostate volume. However, only one patient showed an increase of 3 mL/s or more in maximal flow rate at the end of study. Six patients reported adverse sexual experiences (impotence in 3, decreased rigidity in 1, and decreased libido in 2) and one had GI upset.

A subset of patients with benign prostatic hyperplasia may benefit from treatment with finasteride. Although most patients experienced subjective improvement, increase in maximal flow rate is unsatisfactory in this preliminary report.