PURPOSE: Several studies have shown that finasteride limits hematuria in patients with benign prostatic hyperplasia(BPH). However, there are few reports addressing dutasteride therapy. We evaluated the effect of dutasteride on intraoperative blood loss and on microvessel density(MVD) in patients with BPH. MATERIALS AND METHODS: We studied 39 patients with BPH who underwent transurethral resection of the prostate(TURP). Group I included 22 patients who received dutasteride 0.5mg daily for 2 weeks preoperatively, and group II included 17 patients who did not. Blood loss was evaluated by comparing preoperative and postoperative hemoglobin. Sections from the prostatic suburothelium and hyperplastic prostate were individually stained for CD 34. MVD was calculated by counting the number of positively stained blood vessels in 5 random high power fields. There were no significant differences between the groups in terms of age, total prostatic volume, resected prostatic weight, or prostate-specific antigen (PSA). RESULTS: The mean MVD in the suburethral portion in dutasteride-treated patients was significantly lower than that seen in untreated patients(14.47 versus 22.19 vessels per high power field, p=0.026). In nodular hyperplasia, there was no significant difference in MVD between the two group(14.72 versus 15.24 vessels per high power field, p=0.801). CONCLUSIONS: Short term pretreatment with dutasteride decreases suburethral prostatic MVD in patients with BPH and may help reduce blood loss during TURP, particularly in huge BPH, which sometimes bleeds excessively during operation.
Azasteroids ; Blood Vessels ; Finasteride ; Hematuria ; Hemoglobins ; Humans ; Hyperplasia ; Microvessels ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Dutasteride

The scalp hair is composed of one hundred thousand of hairs. Each hair goes through the three phases of the hair cycle, which causes the hair to turn from an anagen hair into a catagen hair, then into a telogen hair, and finally into a new anagen hair. The number of hairs is maintained at a relatively constant level because each hair has its own hair cycle. The hair of Koreans is relatively thicker than that of Caucasians and Africans but its growth rate and density are lower. There are various factors that influence hair growth such as hormones, nutritional status, and drugs. However, androgen is most important among these factors and, particularly, androgenetic alopecia is caused by androgen and genetic factors. Because excessive dihydrotestosterone produced by 5alpha-reductase is of the greatest importance in androgenetic alopecia, finasteride or dutasteride, which inhibits the action of 5alpha-reductase, is effective in treating androgenetic alopecia. Also, minoxidil is widely used as it promotes hair growth. Furthermore, there are various types of hair diseases and specialized examination is required for differential diagnosis.
Alopecia ; Asian Continental Ancestry Group ; Azasteroids ; Diagnosis, Differential ; Dihydrotestosterone ; Dutasteride ; Finasteride ; Hair ; Hair Diseases ; Humans ; Minoxidil ; Nutritional Status ; Scalp

PURPOSE: To evaluate the effect of preoperative 5-alpha reductase inhibitor (ARI) administration on the operative results of photoselective vaporization of prostate with 120W GreenLight HPS laser. MATERIALS AND METHODS: Data were collected from 98 benign prostatic hyperplasia (BPH) patients who underwent transurethral electrovaporization of prostate by 120W Greenlight HPS laser between Jan. 2010 and Dec. 2010. We compared the time of operation, the energy required in lasering, postoperative maximum uroflow velocity, change in residual urine volume and complications between 5-ARI administrating group and control group. RESULTS: 56 patients administrated 5-ARI at least 3 months before surgery. 30 and 26 patients administrated finasteride and dutasteride, respectively. Mean follow up period was 4.1+/-1.8 months. Mean age of the subjects and mean prostate volume were not different. Mean change of postoperative hemoglobin, lasing time and energy required in lasering were greater in 5-ARI administrating group. There were 3 and 1 cases of acute urinary retension in 5-ARI administrating group and control group, respectively. CONCLUSIONS: The mean change of hemoglobin and mean energy required in lasering were greater and mean lasing time was longer in the patients who administrated 5-ARI before photoselective vaporization of prostate by 120W Greenlight HPS laser. Further investigation and extensive study will be needed to confirm these results.
5-alpha Reductase Inhibitors ; Azasteroids ; Finasteride ; Follow-Up Studies ; Hemoglobins ; Humans ; Oxidoreductases ; Prostate ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Volatilization ; Dutasteride

PURPOSE: To compare the clinical therapeutic efficacy of finasteride and dutasteride as 5-alpha reductase inhibitor (5-ARI) in the medical treatment of benign prostate hyperplasia. MATERIALS AND METHODS: From July 2007 to July 2010, 354 benign prostatic hyperplasia patients with combination medication : alpha blocker plus 5-ARI were enrolled. These patients were classified into a finasteride medication group (F group) and dutasteride medication group (D group) retrospectively. We initially measured the total prostate volume (TPV), prostate specific antigen (PSA), International Prostate Symptom Score (IPSS), quality of life score (QoL), maximal flow rate (Qmax), and post-void residual urine (PVR). After at least twelve months of medication, we rechecked these clinical parameters and during medication, side effects related to medication were also recorded. RESULTS: The F group (n=129) and D group (n=225) showed no differences in baseline characteristics for age, TPV, IPSS, QoL scores, or PSA. After medication, decreases in TPV were relatively higher in the D group than the F group (28.2% vs 20.5%). In addition, the decrease in PSA (43.6% vs 39.2%) and IPSS score (4.6 vs 3.5) were also higher in the D group. There were no significant differences in QoL score, Qmax, PVR change, or side effects between the two groups. CONCLUSIONS: Dutasteride showed greater efficacy in reduction of TPV and PSA and in symptomatic improvement by IPSS score than finasteride. More large scale studies about the differences on clinical efficacy of finasteride and dutasteride are needed.
5-alpha Reductase Inhibitors ; Azasteroids ; Finasteride ; Humans ; Oxidoreductases ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Dutasteride

PURPOSE: To compare and analyze the therapeutic effects and changes in the prostate-specific antigen (PSA) level with treatment with finasteride or dutasteride for benign prostatic hyperplasia (BPH) for 1 year. MATERIALS AND METHODS: We retrospectively investigated patients who suffered from BPH for 1 year between January 2005 and December 2008. For treatment groups, we divided the patients into two groups: one was treated with alfuzosin and finasteride and the other was treated with alfuzosin and dutasteride. At the beginning of treatment, the patients underwent transrectal ultrasonography and measurement of urine flow rate, residual urine volume, PSA, and International Prostate Symptom Score (IPSS). Patients with diseases affecting urinary function were excluded. We not only analyzed the data at the time of initial treatment, but also after 1 year of treatment. A total of 219 patients were able to be evaluated for 1 year. RESULTS: Both finasteride and dutasteride reduced PSA and prostate volume significantly. The comparison between groups showed a more significant reduction of PSA (p=0.020) and prostate volume (p=0.052) in the dutasteride group. Other parameters did not differ significantly between the groups. CONCLUSIONS: 5-alpha Reductase inhibitors for BPH treatment reduced PSA and prostate volume significantly when the patients were treated for 1 year. Administration of dutasteride is considered to be more effective in reducing PSA and prostate volume. Therefore, dutasteride should not be considered equivalent to finasteride in the reduction rate of PSA. The intensity of dutasteride must be reevaluated in comparison with finasteride.
5-alpha Reductase Inhibitors ; Azasteroids ; Finasteride ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quinazolines ; Retrospective Studies ; Dutasteride

Purpose: We assessed the effects of medication with dutasteride on serum prostate-specific antigen (PSA), PSA density (PSAD) and prostate volume to avoid unnecessary biopsies. Materials and Methods: Between 2005 and 2007 patients with serum PSA level of 4~10 ng/ml were recruited in this prospective study. Patients were treated with 0.5 mg of dutasteride once daily for 3 months. PSA, PSAD and prostate volume were measured at baseline and at the end of treatment. The patients with a high PSA level (> or =4 ng/ml) after medication with dutasteride had a prostate biopsy. The patients were divided as group I (prostate cancer; n=29) and group II (benign disease; n=55). We compared the changes of serum PSA, PSAD, and prostate volume change between two groups. Results: In group I, PSA, PSAD and prostate volume decreased from baseline means of 8.16 ng/ml, 0.23 ng/ml/cm3 and 46.81 cc to 5.69 ng/ml, 0.18 ng/ml/cm3 and 40.41 cc. The difference in PSA, PSAD and prostate volume was -0.2%, -2.1% and -3.6% for group I. On the contrary, in group II, PSA, PSAD and prostate volume decreased from baseline means of 7.65 ng/ml, 0.16 ng/ml/cm3 and 56.48 cc to 4.48 ng/ml, 0.11 ng/ml/cm3 and 51.35 cc. The difference in PSA, PSAD and prostate volume was -41.4%, -33.3% and -9.1% for group II. When 4.83 ng/ml and 0.15 ng/ml/cm3 were chosen as the PSA and PSAD cutoff levels after treatment with dutasteride, unnecessary biopsies could be avoided effectively. Conclusions: These data suggest that the magnitude of changes in serum PSA and PSAD after 3 months of dutasteride challenge could be useful to avoid unnecessary prostate biopsies in patients with elevated PSA level.
Azasteroids ; Biopsy ; Humans ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Dutasteride

Benign prostatic hyperplasia (BPH) is a common disease in older men. At present, 5alpha reductase inhibitor-based medication, preferred by most BPH patients as the first-choice therapy, is taking place of traditional transurethral resection of the prostate. This article presents an update of the researches on the treatment of BPH with dutasteride--a novel 5 alpha-reductase inhibitor.
5-alpha Reductase Inhibitors ; therapeutic use ; Azasteroids ; therapeutic use ; Dutasteride ; Humans ; Male ; Prostatic Hyperplasia ; drug therapy

The key enzyme in the androgen synthesis and androgen receptor pathways is 5alpha-reductase (5-AR), which occurs as three isoenzymes. Types I and II 5-ARs the most important clinically, and two different 5-AR inhibitors (5-ARIs), finasteride and dutasteride, have been developed. Several urology associations have recommended and upgraded the use of 5-ARIs for an enlarged prostate with lower urinary tract symptoms. In the Prostate Cancer Prevention Trial and the Reduction by Dutasteride of Prostate Cancer Events Trial, 5-ARIs reduced the incidence of low-grade prostate cancer. However, despite the documented reductions in the overall incidence of prostate cancer, 5-ARIs are at the center of a dispute. The American Society of Clinical Oncology (ASCO) and the American Urology Association (AUA) presented clinical guidelines for the use of 5-ARIs for chemoprevention of prostate cancer in 2008. However, ASCO/AUA has eliminated these from the main "Clinical Guidelines" in 2012, because the U.S. Food and Drug Administration denied a supplemental New Drug Application for the use of dutasteride for prostate cancer chemoprevention. The 5-ARIs can also be used to manage hemospermia and prostatic hematuria, and to prevent intraoperative bleeding, although there is insufficient evidence for a standard strategy. This review summarizes the current use of 5-ARIs for prostate disease, including benign prostate hyperplasia, prostate cancer, prostate-related bleeding, and hemospermia.
Azasteroids ; Chemoprevention ; Disease Management ; Dissent and Disputes ; Finasteride ; Hematuria ; Hemorrhage ; Hemospermia ; Hyperplasia ; Incidence ; Isoenzymes ; Lower Urinary Tract Symptoms ; Medical Oncology ; Prostate ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Receptors, Androgen ; United States Food and Drug Administration ; Urology ; Dutasteride

Prostate cancer can be prevented more easily than other types of cancers, thanks to the following reasons: The presence of precursor lesions, longer doulbling time of cancerous cells, high incidence and prevalence, and susceptibility to chemo-preventive agents such as 5 alpha reductase inhibitor (5ARI). The following risk factors may increase the incidence of prostate cancer: age (older than 50), family history of prostate cancer, race (African-American), hormones (testosterone, dehydrotestosterone), and diet high in dairy foods and calcium. The following protective factors may decrease the risk of prostate cancer: Lycopene, Soy, Green tea, Vit. D, and taking Finasteride or Dutasteride. The following have not been proven to prevent prostate cancer: Selenium, vitamin E, retinoid, and multivitamins. However, their effectiveness is still under investigation. Avoiding risk factors such as smoking, being overweight and lack of exercise may help prevent cancers. Increasing protective factors such as quitting smoking, eating a healthy diet and exercising may also help prevent cancers. Some clinical studies are conducted on polyphenon E for high grade PIN, Vitamin D, fish oil, green tea, and aspirin for prostate cancer prevention. Prostate cancer is an attractive and appropriate target for cancer prevention because of its incidence, prevalence and disease-related mortality. In addition to changing life style with healthy food and reducing dairy and calcium intake, taking certain drugs (5ARI) may prevent cancer development.
Aspirin ; Azasteroids ; Calcium ; Carotenoids ; Catechin ; Cholestenone 5 alpha-Reductase ; Continental Population Groups ; Diet ; Dutasteride ; Eating ; Finasteride ; Humans ; Incidence ; Life Style ; Overweight ; Prevalence ; Prostate ; Prostatic Neoplasms ; Risk Factors ; Selenium ; Smoke ; Smoking ; Tea ; Vitamin D ; Vitamin E ; Vitamins

PURPOSE: Sexual adverse events (AEs), a major cause for discontinuing 5alpha-reductase inhibitor (5ARI) therapy for benign prostatic hyperplasia (BPH), are known to occur most frequently early in therapy and appear to decline over time. The aim of this study was to investigate the changes in sexual function occurring with dutasteride treatment during a 1-year follow-up period in Korean men. MATERIALS AND METHODS: Using the International Index of Erectile Function, we prospectively evaluated, after 1, 3, 6, 9, and 12 months of treatment, the changes in sexual function of 55 outpatients (mean age 62.3+/-7.2 years) with BPH (mean volume 48.9+/-16.0 g) who had relatively good erectile function (EF) and were treated with dutasteride for at least 1 year. RESULTS: EF scores showed the most significant decrease at 1 month (p<0.01). Function gradually recovered thereafter but was still significantly decreased after 12 months of treatment (p<0.05). The scores for orgasmic function and sexual desire also showed the most significant reduction at 1 month but were restored to the baseline level at 6 months. No significant correlation was observed between changes in sexual function and prostate-specific antigen level, prostate volume, or International Prostate Symptom Scores. CONCLUSIONS: After 1 month of treatment, dutasteride therapy resulted in a significant reduction in all investigated sexual functions. Overall, recovery in sexual function was noted at 3 months, and orgasmic function and sexual desire were restored to baseline levels at 6 months. However, EF was still significantly reduced at 12 months.
Azasteroids ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Orgasm ; Outpatients ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Dutasteride