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

Erectile dysfunction is a common side effect of finasteride and dutasteride treatments. The objective of this study was to investigate the structural changes in the penis using a benign prostatic hyperplasia (BPH) rodent model treated with dutasteride or finasteride. Sixty male rats were divided into the following groups: C, untreated control rats; C + D, control rats receiving dutasteride; C + F, control rats receiving finasteride; H, untreated spontaneously hypertensive rats (SHRs); H + D, SHRs treated with dutasteride; and H + F, SHRs treated with finasteride. Treatments were performed for 40 days, and penises were collected immediately thereafter. The organs were analyzed using histomorphometric methods to determine the cross-sectional penile area, as well as the surface density (Sv) of smooth muscle fibers, connective tissue, elastic system fibers, and sinusoidal spaces of the corpus cavernosum. The results were compared using a one-way ANOVA with Bonferroni's posttest. Groups C + D and C + F had a significantly smaller penile cross-sectional area, but more elastic system fiber Sv compared to Group C. Group C + D showed less smooth muscle Sv, and Group H showed more connective tissue but a smaller sinusoidal space Sv in the corpus cavernosum compared to Group C. Groups H + D and H + F had less smooth muscle Sv than Group H. Group H + D also had more connective tissue and elastic system fiber Sv than Group H. Both dutasteride and finasteride promoted penile modifications in the control rat penis, although this affect was greater in Group H animals. In this rodent model, dutasteride was the drug that most affected the corpus cavernosum.
5-alpha Reductase Inhibitors/therapeutic use* ; Animals ; Disease Models, Animal ; Dutasteride/therapeutic use* ; Finasteride/therapeutic use* ; Male ; Muscle, Smooth/pathology* ; Myocytes, Smooth Muscle/pathology* ; Penis/pathology* ; Prostate/pathology* ; Prostatic Hyperplasia/pathology* ; Rats

AIMTo describe an unusual symptom of benign prostatic hyperplasia (BPH).

METHODSA patient presented to our urology clinic having experienced post-coital gross hematuria for 2 years. He had not experienced lower urinary tract symptoms (LUTS). A series of examinations were performed to determine the source of bleeding.

RESULTSThe prostate was defined as the active bleeding source responsible for the patient's post-coital hematuria. Endoscopic fulguration did not alleviate the symptom. The use of dutasteride, a dual inhibitor of 5alpha-reductase, solved the problem.

CONCLUSIONThis study reports for the first time that post-coital gross hematuria is one of the clinical presentations of BPH, which can be successfully treated with 5alpha-reductase inhibitor.

5-alpha Reductase Inhibitors ; Azasteroids ; therapeutic use ; Coitus ; physiology ; Dutasteride ; Enzyme Inhibitors ; therapeutic use ; Hematuria ; drug therapy ; etiology ; physiopathology ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; diagnosis ; physiopathology ; Urinary Tract