PURPOSE: The aim of this study was to evaluate the efficacy of a combination drug therapy (tamsulosin plus finasteride) for benign prostatic hyperplasia, with a small prostate volume of less than 40 grams. MATERIALS AND METHODS: One hundred and twenty-three patients, with symptomatic benign prostatic hyperplasia of less than 40 grams, were analysed. Group 1 (n=67) had been treated with a combination of finasteride (5mg/day) and tamsulosin (0.2mg/ day), and Group 2 (n=56) with tamsulosin only (0.2mg/day) over a 12 month period. The patients were periodically assessed by IPSS (international prostate symptom score), uroflowmetry and residual urine, during the treatment period. RESULTS: The mean changes in the total symptom score, obstructive and irritative symptom score for group 1 and group 2 at 1 year were -7.21+/-7.44 (39.86%), -4.79+/-5.07 (45.02%) and -2.42+/-3.25 (48.11%), and -7.39+/-9.98 (43.06%), -4.82+/-6.91 (45.21%) and -2.39+/-4.00 (37.82%) points, respectively. The mean changes in the peak urinary-flow rates and postvoid residual urine for group 1 and group 2 at 1 year were 2.07+/-5.42 (16.65%)ml/s and -31.58+/-60.99 (56.47%)ml, and 2.38+/-6.57 (16.53%)ml/s and -34.78+/-86.77 (50.24%)ml, respectively. The effects of the combination of finasteride and tamsulosin were no greater than the tamsulosin monotherapy (p>0.01). CONCLUSIONS: A combination of finasteride and tamsulosin is no more effective than tamsulosin alone, in patients with benign prostatic hyperplasia, with a prostate volume of less than 40 grams.
Drug Therapy, Combination ; Finasteride* ; Humans ; Prostate* ; Prostatic Hyperplasia*

Benign prostatic hyperplasia (BPH) is a worldwide common disease in men over 50 years old, and the exact cause of BPH remains largely unknown. In order to elucidate its pathogenesis and screen effective drugs for the treatment of BPH, many BPH models have been developed at home and abroad. This article presents a comprehensive analysis of the categories and characteristics of BPH drug evaluation models, highlighting the application value of each model, to provide a theoretical basis for the development of BPH drugs.
Animals ; Disease Models, Animal ; Drug Design ; Drug Evaluation ; Male ; Prostatic Hyperplasia ; drug therapy

Saw palmetto fruit extract (SPE), as a herbal product, is widely used for the treatment of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Recent studies show that SPE also has some therapeutic effects on chronic prostatitis, prostate cancer, sexual dysfunction, and so on. This article presents an overview on the application of SPE in the treatment of BPH, prostate cancer, and chronic prostatitis/chronic pelvic pain syndrome, with a discussion on its action mechanisms.
Chronic Disease ; Fruit ; chemistry ; Humans ; Lower Urinary Tract Symptoms ; drug therapy ; Male ; Pelvic Pain ; drug therapy ; Plant Extracts ; therapeutic use ; Prostatic Diseases ; drug therapy ; Prostatic Hyperplasia ; drug therapy ; Prostatic Neoplasms ; drug therapy ; Prostatitis ; drug therapy ; Syndrome

OBJECTIVETo study the different features of hyperplasia in castrated and uncastrated mice after testosterone (T) treatment.

METHODSForty-eight BALB/c mice were randomly divided into 6 groups of 8 in each: castrated (A), uncastrated (B) , castrated + low T (C), uncastrated + low T (D), castrated + high T (E), uncastrated + high T (F). Groups C and D were treated with testosterone solution at the dose of 12.5 mg/(kg d) and Groups E and F at 125 mg/(kg d) for 20 consecutive days, while Groups A and B received saline only. All the mice were sacrificed on the 21st day, their ventral and dorsal prostate glands weighed and their pathological features studied.

RESULTSAtrophic prostates were observed in Group A, but normal in Group B; prostatic hyperplasia was found in both Group C and D, but more obvious in the latter (P <0.05); and a slightly higher degree of hyperplasia was noted in Groups E and F than in C and D. There was an increase in serum T and vascular endothelial growth factor (VEGF) concentration and a decrease in serum estrogen (E2) concentration in the testosterone treated groups.

CONCLUSIONBoth castrated and uncastrated mice develop prostate hyperplasia after short-term testosterone treatment, although in different degrees and with different features, which may help further the studies on the association of castration and androgen with prostate diseases.

Animals ; Hyperplasia ; Male ; Mice ; Mice, Inbred BALB C ; Orchiectomy ; Prostate ; pathology ; Prostatic Hyperplasia ; drug therapy ; pathology ; Testosterone ; therapeutic use

Since it has shown that the smooth muscle is the dominant cellular constituent of the hyperplastic prostate and outlet obstruction in benign prostatic hyperplasia (BPH) is mediated by sympathetic nerve system via prostatic smooth muscle alpha 1 receptor, various kinds of alpha blocker have been tried in the treatment of BPH with moderate effectiveness. From May 1994 to December, 1994, a randomized placebo-controlled double blind study of long-acting selective alpha 1 blocker terazosin was undertaken to evaluate short-term effects of pharmacotherapy for BPK Of 80 patients with symptomatic BPH who were randomized to receive placebo or terazosin, 42 completed the study. At baseline, the irritative, obstructive and total symptom score (mean+/-SD) were 8.4+/-3.3, 11.8+/-4.9, 20.2+/-7.6 in placebo group and 8.3+/-4.3, 12.1 +4.6, 20.4 +7.3 in terazosin group and the peak and mean urinary flow rate (ml/ sec) were 10.7+/-2.6 and 5.5+/-2.0 in placebo group and 9.8+/-3.6 and 5.1+/-2.1 in terazosin group. After 28 days trial, the irritative, obstructive and total symptom score (mean+/-SD) were 7.4+/-3.8, 9.3+/-5.6, 16.8+/-9.2 in placebo group and 5.2+/-3.6, 6.2+/-4.0,11.4+/-6.6 in terazosin group(p<0.05, p<0.05 and p<0.01) and the peak and mean urinary flow rate (ml/sec) were 11.1+/-5.1 and 5.8+/-3.1 in placebo group and 14.7+/-6.4, 8.0+/-3.9 in terazosin group. (p<0.01 and p<0.01) At least 30% improvement in total symptom score and peak flow rate were observed in 67% (14/21) and 76% (16/21) of patients respectively in terazosin group. The common side effects were mild dizziness in 5(22%) in terazosin group and 1(5%) in placebo group but premature termination was observed in only 2(9%) patients in terazosin group and 1(5%) in placebo group. The mean change in baseline systolic pressure was 2mmHg for normotensive group and 19mmHg for hypertensive group. In conclusion, this study showed beneficial short term result for the safety and efficacy of long acting selective alpha 1 blocker terazosin in the management of symptoms of BPH However, the durability of the safety and efficacy of terazosin needs to be evaluated for longer periods.
Blood Pressure ; Dizziness ; Double-Blind Method* ; Drug Therapy ; Humans ; Muscle, Smooth ; Prostate ; Prostatic Hyperplasia*

Benign Prostatic Hyperplasia is one of the most important desease with a high frequency in urology. There is no doubt that the main stream of treatment is transurethral resection. of the prostate, however, marked improvement in drug therapy has been observed in recent years. Allylestrenol is a synthetic gestagen which was known to act directly on the prostate to exhibit its effect of reducing the size of the prostate by inhibiting the selective uptake of serum testosterone, inhibition of metabolism of testosterone to 5a-DHT (dihydrotestosterone) reductase, inhibition of 5a-DHT receptor binding. Our present study was carried out on 108 patients with benign prostatic hyperplasia to evaluate the efficacy and safety of antiandrogen therapy with allylestrenol. Allylestrenol was administered in a dose of 25 mg twice a day in the morning and evening after meal for 12 weeks to the patients and its efficacy was evaluated with peak urinary flow rate, Madsen Symptom Score at 4, 12 weeks after treatment and prostate volume at 12 weeks after treatment. Of these patients 46 completed the study and only 2 patients withdrew from the study owing to side effects. However,these side effects were not serious. At baseline (mean +SD) the mean peak urinary flow rate was 11.0+/-3.7 ml/sec, mean symptom score 10.2+4.0 and mean ultrasonic assessment of prostatic volume 36.8 +/-9.6 gm. At 4 weeks after treatment(mean + SD) mean peak urinary flow rate was 12+/-3.5 ml/sec, mean symptom score 7.7+/-4.2 (p > .0.05, p < 0.05). At 12 weeks after treatment (mean +SD) mean peak urinary flow rate was 12.8+4.7 ml/sec, mean symptom score 7.0+4.2 and mean ultrasonic assessment of prostatic volume 36.6+/-9.3 gm (p < 0.05, p < 0.05, p > 0.05).
Allylestrenol* ; Drug Therapy ; Humans ; Meals ; Metabolism ; Oxidoreductases ; Prostate ; Prostatic Hyperplasia* ; Rivers ; Testosterone ; Ultrasonics ; Urology

OBJECTIVETo assess the efficacy and safety of Saw Palmetto Extract Capsules in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe conducted a multi-centered open clinical study on 165 BPH patients treated with Saw Palmetto Extract Capsules at a dose of 160 mg qd for 12 weeks. At the baseline and after 6 and 12 weeks of medication, we compared the International Prostate Symptom Scores (IPSS), prostate volume, postvoid residual urine volume, urinary flow rate, quality of life scores (QOL), and adverse events between the two groups of patients.

RESULTSCompared with the baseline, both IPSS and QOL were improved after 6 weeks of medication, and at 12 weeks, significant improvement was found in IPSS, QOL, urinary flow rate, and postvoid residual urine. Mild stomachache occurred in 1 case, which necessitated no treatment.

CONCLUSIONSaw Palmetto Extract Capsules were safe and effective for the treatment of BPH.

Capsules ; Humans ; Male ; Plant Extracts ; adverse effects ; therapeutic use ; Prostatic Hyperplasia ; drug therapy ; Quality of Life

OBJECTIVETo observe the clinical efficacy of Qianlie Sanyu Capsule on benign prostatic hyperplasia (BPH).

METHODSSeventy-two patients with BPH were randomly divided into a treatment group (40 patients) and a control group (32 patients), the former treated by Qianlie Sanyu Capsule and the latter by Longbishu. Observation were made on the changes of the patients' urination' symptoms, living quality, prostatic volume, Qmax uroflowmetry and excel urine before and after treatment.

RESULTSThe total efficacy rates were 92.5% in the treatment group, and 72.5% in the control group. Comparison between the two groups showed significant difference (P < 0.01). The urination symptoms, living quality, Qmax uroflowmetry and the excel urine were better improved in the Qianlie Sanyu group than in the Longbishu. There were significant differences between the two groups (P < 0.05), but none in reducing effect on the prostatic volume.

CONCLUSIONQianlie Sanyu Capsule is an effective drug for BPH.

Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Phytotherapy ; Prostatic Hyperplasia ; drug therapy

OBJECTIVETo make a system review of the effects of Bushenhuoxue (kidney-tonifying and blood-activating prescription), a category of compound Chinese medicines, on benign prostatic hyperplasia (BPH) and its side effects.

METHODSAll the research articles about Chinese medicines treating BPH from January 1978 to February 2003 were retrieved using the methods of international evidence-based medicine (EBM), and their qualities were evaluated based on JADAD standard and concealment of research allocation. Then the included articles went through META-analysis with Revman 4.2 software.

RESULTSThe efficacy of Bushenhuoxue on BPH was better than Qianliekang but not statistically different from finasteride. The combined use of Bushenhuoxue with surgery had no statistical difference from mere surgical treatment. Four articles reported the side effects of this compound Chinese medicine including upset and pain in the abdomen, nausea, diarrhea and dryness of the nose.

CONCLUSIONMassive, multi-center and randomized controlled clinical trials should be conducted to find out more effective methods for treating BPH with Chinese medicines based on the improvement of measurable symptom evaluation method and for evaluating their side effects.

Drugs, Chinese Herbal ; therapeutic use ; Evidence-Based Medicine ; Humans ; Male ; Phytotherapy ; Prostatic Hyperplasia ; drug therapy

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