Benign prostatic hyperplasia (BPH) is a chronic male disease characterized by the enlarged prostate. Celtis chosenianaNakai (C. choseniana) is medicinally used to alleviate pain, gastric disease, and lung abscess. In this study, the effect of C. choseniana extract on BPH was investigated using testosterone-induced rats. Sprague Dawley rats were divided into five groups: control, BPH (testosterone 5 mg·kg^-1), Fina (finasteride 2 mg·kg^-1), and C. choseniana (50 and 100 mg·kg^-1). After four weeks of TP treatment with finasteride or C. choseniana, prostate weights and DHT levels were measured. In addition, the prostates were histopathologically examined and measured for protein kinase B (Akt)/nuclear factor-κB (NF-κB)/AR signaling, proliferation, apoptosis, and autophagy. Prostate weight and epithelial thickness were reduced in the C. choseniana groups compared with that in the BPH group. The extract of C. choseniana acted as a 5α reductase inhibitor, reducing DHT levels in the prostate. Furthermore, the extract of C. choseniana blocked the activation of p-Akt, nuclear NF-κB activation and reduced the expression of AR and PSA compared with BPH. Moreover, the expression of Bax, PARP-1, and p53 increased, while the expression of bcl-2 decreased. The present study demonstrated that C. choseniana extract alleviated testosterone-induced BPH by suppressing 5α reductase and Akt/NF-κB activation, reducing AR signaling and inducing apoptosis and autophagy in the prostate. These results suggested that C. choseniana probably contain potential herbal agents to alleviate BPH.
Animals ; Cholestenone 5 alpha-Reductase/metabolism* ; Finasteride/adverse effects* ; Male ; NF-kappa B/genetics* ; Plant Extracts/therapeutic use* ; Prostatic Hyperplasia/drug therapy* ; Proto-Oncogene Proteins c-akt/genetics* ; Rats ; Rats, Sprague-Dawley ; Receptors, Androgen/metabolism* ; Testosterone ; Ulmaceae/metabolism*

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

Objective: To explore the effects of Kudzu Root plus Cinnamon Granules (KR+C) on prostatic hyperplasia (PH) in mice. METHODS: Sixty 4-week-old Kunming male mice were randomly divided into six groups: blank control, PH model, high-, medium- and low-dose KR+C, and finasteride control. All the mice except those in the blank control group were subcutaneously injected with testosterone propionate (5 mg / ［kg·d］) at 7 days after surgical castration. The animals of different groups were treated intragastrically with different doses of KR+C, finasteride, and normal saline respectively for 3 weeks and then sacrificed for weighing of the prostate, calculation of the prostatic index, observation of the morphological changes in the prostate after HE staining, determination of the expressions of FGF2, Ki67 and TGF-β1 by immunohistochemistry, detection of 5α-reductase activity by ELISA, and measurement of the apoptosis index of the prostatic cells by TUNEL. RESULTS: Compared with the model controls, the mice of the other groups showed significantly reduced prostatic volume (P <0.05), prostatic index (P <0.05), expressions of FGF2, Ki67 and TGF-β1, and activity of 5 α-reductase (P <0.05), but remarkably increased apoptosis index of the prostatic cells (P <0.05). However, no statistically significant differences were observed in the above parameters between the finasteride control and the three KR+C groups (P>0.05). CONCLUSIONS KR+C can reduce the prostatic volume of PH mice by decreasing the activity of 5α- reductase, inhibiting the expressions of FGF2, Ki67 and TGF-β1, and promoting the apoptosis of prostatic cells.
Animals ; Apoptosis ; Cholestenone 5 alpha-Reductase ; metabolism ; Cinnamomum zeylanicum ; chemistry ; Fibroblast Growth Factor 2 ; metabolism ; Finasteride ; therapeutic use ; In Situ Nick-End Labeling ; Ki-67 Antigen ; metabolism ; Male ; Mice ; Organ Size ; Phytotherapy ; methods ; Plant Roots ; chemistry ; Prostate ; pathology ; Prostatic Hyperplasia ; drug therapy ; metabolism ; pathology ; Pueraria ; chemistry ; Random Allocation ; Testosterone Propionate ; administration & dosage ; Transforming Growth Factor beta1 ; metabolism ; Urological Agents ; therapeutic use

OBJECTIVETo evaluate the clinical effectiveness of transurethral seminal vesiculoscopy (TUSV) combined with finasteride in the treatment of recurrent hemospermia.

METHODSThis study included 32 patients with recurrent hematospermia, with the disease course of 3 months to 4 years. After administration of finasteride at 5 mg/d for 2 weeks, the patients underwent TUSV for both exploration of the causes and treatment, followed by medication with finasteride at the same dose for another 2 weeks. Postoperative follow-up was conducted for observation of the outcomes and complications.

RESULTSTUSV was successfully accomplished in all the 32 cases, which revealed 16 cases of seminal vesiculitis, 10 seminal calculi, 1 seminal vesicle cyst, 2 seminal vesicle polyps, and 3 seminal vesicle abscess. The operative time was 20 to 51 (31.0 +/- 5.2) minutes. Postoperative complications included 1 case of acute epididymitis and 3 cases of breast discomfort within the first 4 weeks. No incontinence, urethral stricture, rectal injury, retrograde ejaculation, and sexual dysfunction occurred postoperatively. All the patients but 1 were followed up for 6 months to 2 years. Twenty-nine of the cases were cured, and 2 experienced recurrence.

CONCLUSIONTransurethral seminal vesiculoscopy combined with finasteride is safe and effective for the treatment of recurrent hemospermia.

Adult ; Endoscopy ; methods ; Finasteride ; therapeutic use ; Follow-Up Studies ; Hemospermia ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

PURPOSE: To investigate the effect of metabolic syndrome (MetS) on the response to medical therapy of benign prostatic hyperplasia (BPH) after a 3-month period of treatment. MATERIALS AND METHODS: This was a cohort study of 100 patients, 47 with MetS and 53 without MetS, referred to either the primary care unit or referral hospital with BPH who had moderate lower urinary tract symptoms of prostate involvement and were candidates for medical treatment. Our main outcome was response to medical treatment with prazosin 1 mg twice a day and finasteride 5 mg daily in patients with BPH on the basis of International Prostate Symptom Score (IPSS). Multivariate analysis of covariance was used to compare BPH treatment response in patients with and without MetS before and after receiving treatment. RESULTS: The mean volume of the prostate was significantly higher in MetS patients than in patients without MetS (57+/-32.65 mL compared with 46.00+/-20.19 mL, p=0.036). The control group demonstrated an 11-unit reduction in IPSS, whereas those with MetS showed a reduction in the symptom score of only 6 units (p<0.001). Regarding the components of MetS separately, triglyceride (p<0.001), fasting blood sugar (p=0.001), and waist circumference (p=0.028) significantly affected the clinical progression of BPH. The observational nature of this study may be a limitation in comparison with an interventional study. CONCLUSIONS: The results of the present study showed that MetS can negatively affect the response to medical treatment of BPH. Therefore, it is necessary to consider MetS in selecting patients with BPH for drug therapy.
Aged ; Case-Control Studies ; Finasteride/*therapeutic use ; Humans ; Lower Urinary Tract Symptoms/etiology ; Male ; Metabolic Syndrome X/*complications ; Middle Aged ; Patient Selection ; Prazosin/*therapeutic use ; Prostatic Hyperplasia/complications/*drug therapy/pathology ; Treatment Outcome ; Urological Agents/*therapeutic use

OBJECTIVETo investigate the factors influencing the compliance, discontinuation and switching of finasteride medication in patients with benign prostatic hyperplasia (BPH).

METHODSWe retrospectively analyzed the electronic clinical data of 655 outpatients with BPH treated with finasteride from January 2008 to June 2010. Using the medication possession ratio (MPR), we measured their medication compliance and the rates of discontinuation and switching after an average observation of 12 months. We identified and evaluated the influencing factors by multivariate logistic regression analysis.

RESULTSThe crude rates of medication compliance, discontinuation and switching were 32.4%, 58.0% and 9.6%, respectively. In those aged > or = 60 years, combination therapy of finasteride with alpha-receptor blockers and chronic comorbidities were positively associated with good compliance, while younger age was significantly associated with drug discontinuation or switching. Finasteride monotherapy was significantly associated with discontinuation of the drug.

CONCLUSIONPatients aged < 60 years and those receiving monotherapy were less likely to be compliant with newly initiated finasteride medication, and therefore more efforts should be made to increase their medication adherence.

Aged ; Aged, 80 and over ; Female ; Finasteride ; therapeutic use ; Humans ; Male ; Medication Adherence ; Middle Aged ; Outpatients ; Prostatic Hyperplasia ; drug therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo systematically evaluate the effects of finasteride on hematuria associated with benign prostatic hyperplasia (BPH).

METHODSWe electronically searched MEDLINE (December 1966-April 2009), EMBASE (December 1974-April 2009), The Cochrane Library (Issue 1, 2009), CNKI (December 1994-April 2009), VIP (December 1989-April 2009) and CBM (December 1978-April 2009) , and handsearched several relevant journals as well. Randomized controlled trials were assessed with the methods recommended by the Cochrane Collaboration. The data were screened and systematically analyzed by at least two reviewers independently using the RevMan 5.0 software.

RESULTSCompared with the placebo control group, the finasteride group showed a significantly decreased incidence of hematuria during the 12 months follow-up period (OR 0.11, 95% CI: 0.06-0.21, P < 0.05).

CONCLUSIONFinasteride has desirable therapeutic and preventive effects on BPH-associated hematuria. More well-designed multicentered randomized controlled trials of large sample size are invited to provide further evidence for this conclusion.

Finasteride ; therapeutic use ; Hematuria ; drug therapy ; etiology ; prevention & control ; Humans ; Male ; Prostatic Hyperplasia ; complications ; drug therapy ; Randomized Controlled Trials as Topic

OBJECTIVETo analyze the influence of benign prostatic hyperplasia (BPH) drugs on incidence and pathology grading of prostate cancer in China.

METHODSRetrospectively investigated the history of drug treatment in 1029 cases of BPH in patients from February 1998 to December 2004. According to the history of drug use, the patients were divided into 4 groups: finasteride group, alpha-receptor inhibitor group, finasteride and alpha-receptor inhibitor combination group and control group (untreated group). We gathered pathology sections of patients in all groups, and gave Gleason Score to each. The difference of incidence and pathology grading of prostate cancer were analyzed by Stata 7.0.

RESULTSThe incidence of prostate cancer in the population of our study was 13.5%; The incidence in finasteride group, alpha-receptor inhibitor group, combination group and control group was 9.8%, 16.0%, 10.3% and 18.6%, respectively. There was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05). In our study, the ratio of middle or high level pathology grading (Gleason ≥ 7) in prostate cancer patients was 58.3%, the ratio of middle or high level pathology grading prostate cancer patients in the four groups was 71.4%, 59.6%, 67.7% and 40.0%, respectively. In the comparison of composition ratio of middle or high level prostate cancer, there was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05).

CONCLUSIONSFinasteride can lower the risk of prostate cancer, but increase the pathology grade of the prostate cancer which has occurred in the same time. The alpha-receptor inhibitor does not have the same effect.

Adrenergic alpha-Antagonists ; therapeutic use ; Aged ; Aged, 80 and over ; Finasteride ; therapeutic use ; Humans ; Incidence ; Male ; Middle Aged ; Prostatic Hyperplasia ; drug therapy ; Prostatic Neoplasms ; epidemiology ; pathology ; Retrospective Studies

OBJECTIVETo study the effect of finasteride on benign prostatic hyperplasia (BPH) related gross hematuria in patients receiving anticoagulant.

METHODSA total of 105 patients with BPH related gross hematuria were divided into an anticoagulant group (n = 81), treated with combined therapy of anticoagulants and finasteride, and a control group (n = 24), given finasteride only at 5 mg daily. The therapeutic effects were compared by a 6-month follow-up.

RESULTSIn the anticoagulant group, gross hematuria was cured in 52 patients (64.2%), taking an average time of 3.9 weeks (1-6 weeks), and improved in 12 patients (14.8%), as compared with 16 patients cured (66.7%), 3.2 weeks taken (1-5 weeks), and 4 patients improved (16.7%) in the control group. The mean time taken to resolve hematuria was longer in the former (P < 0.05). But the cure rates had no significant differences either between the two groups or among the subgroups receiving different anticoagulants.

CONCLUSIONFinasteride is an effective therapeutic for BPH related hematuria in patients receiving different anticoagulants. It makes no significant differences in cure and effectiveness rates between patients treated with and without anticoagulant, but takes an average of longer time to resolve hematuria in patients receiving anticoagulant.

Aged ; Aged, 80 and over ; Anticoagulants ; therapeutic use ; Fibrinolytic Agents ; therapeutic use ; Finasteride ; therapeutic use ; Follow-Up Studies ; Hematuria ; drug therapy ; etiology ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; drug therapy ; Treatment Outcome

OBJECTIVETo report the effect of Fengweicao Granule (FWCCG), a Chinese herbal preparation made of herba Pteris multifidae, in treating benign prostatic hyperplasia (BPH).

METHODSOne hundred and fifty-five patients were assigned to two groups, the 108 patients in the treated group were administered orally with FWCG twice a day, 5 g every time; the 47 patients in the control group were treated with Proscar 5 mg per day for 3 months. The effects were evaluated by the change of the related indexes before and after treatment, including scoring by international prostatic symptom scale (I-PSS), maximum flowing rate of urine (MFR), residue urine volume (RU) in urinary bladder determined by abdominal B-ultrasonography and volume of prostate.

RESULTSAfter being treated for 3 months, the I-PSS, MFR and RU improved remarkably in both groups (P <0.05 or P <0.01), but with no significant change in the volume of prostate, neither with significant difference in comparison between the two groups (P >0.05).

CONCLUSIONFWCG has a good effect with less adverse reaction in treating BPH.

Diuresis ; drug effects ; Drugs, Chinese Herbal ; therapeutic use ; Enzyme Inhibitors ; therapeutic use ; Finasteride ; therapeutic use ; Humans ; Male ; Medicine, Chinese Traditional ; Prostatic Hyperplasia ; drug therapy ; Pteris