scholarly journals Efficacy and Safety of Combine Alfuzosin and Finasteride in the Treatment of Symptomatic Benign Prostatic Hyperplasia: A Quasi-Experimental Study

2018 ◽  
Vol 16 (2) ◽  
pp. 35-39
Author(s):  
Md Saifuddin Ahmed Siddique ◽  
Sharmin Nahar Bashar ◽  
Farid Uddin Ahmed
Keyword(s):  
Experimental Study ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Flow Rate ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Efficacy And Safety ◽  
Quasi Experimental

Background: Lower Urinary Tract Symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) are common in elder men and a number of drugs alone or in combination are clinically used for this disorder. To assess the efficacy and safety of combined Alfuzosin plus Finasteride, in patients with LUTS due to BHP.Methods: In this hospital-based, Quasi-experimental study (One-Group Pre test-Post test Design) without Control Groups, 30 consecutive patients were selected as per set criteria for medical management of BPH with combination of 10mg Alfuzosin and 5mg Finasteride, for 12-months, in the outpatient Department of Urology, in Chittagong Medical College Hospital. The primary efficacy criteria were improvement in symptoms (International Prostate Symptom Score (IPSS) peak urinary flow rate and reduction of prostate volume from baseline.Results: Combination therapy with Alfuzosin plus Finasteride was effective in improving the symptoms and peak urinary flow rate from the first follow-up visit (Day 90) in comparison to baseline score. The mean change in the IPSS from baseline at endpoint was 10±1.87 (p=0.001). The percentage increase in the peak urinary flow rate was 4.8 mL/s, compared with 11.0±1.82 mL/s at baseline (p=0.001). The patients’ quality of life also significantly improved. The percentage decrease in prostate volume at end point was 15.13±11.3 cc (p=0.001). Overall, this combination therapy was well tolerated. The incidence of orthostatic hypotension as determined by systematic blood pressure measurements was only 3(10%). No clinically relevant ejaculation disorders were observed.Conclusion: Alfuzosin plus Finasteride provides effective relief from the symptoms of benign prostatic hyperplasia by reducing the size of the prostate. It is well tolerated from a cardiovascular viewpoint and is not associated with abnormal ejaculation.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 35-39

scholarly journals Body Mass Index and Risk of Prostate Volume, International Prostate Symptom Score, Maximum Urinary Flow Rate, and Post-Void Residual in Benign Prostatic Hyperplasia Patients

2019 ◽  
Vol 13 (4) ◽  
pp. 155798831987038 ◽  
Author(s):  
Bing-Hui Li ◽  
Tong Deng ◽  
Qiao Huang ◽  
Hao Zi ◽  
Hong Weng ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Benign Prostatic Hyperplasia ◽  
Body Mass ◽  
Flow Rate ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Increased Risk ◽  
Maximum Urinary Flow

The objective of this study was to evaluate association between body mass index (BMI) and prostate volume (PV), international prostate symptom scores (IPSS), maximum urinary flow rate ( Qmax), and post-void residual (PVR) of Chinese benign prostatic hyperplasia (BPH) patients. All newly diagnosed BPH patients between September 2016 and August 2018 were selected and 788 patients were included. According to BMI, the patients were categorized into four groups, while according to PV, IPSS, Qmax, and PVR, they were categorized into two groups based on clinical significant cutoffs. Univariable and multivariable logistic regressions and a restricted cubic spline (RCS) were applied to explore the relationship of BMI with categorical PV, IPSS, Qmax, and PVR. Compared with normal BMI, obesity presented significant association with increased risk of larger PV (>80 ml) in both unadjusted and adjusted models (unadjusted odds ratio [OR] = 1.772, 95% CI [1.201, 2.614], p = .004; adjusted OR = 1.912, 95% CI [1.212, 3.017], p = .005); however, underweight or overweight did not present a significant connection with such risk. No significant effect was identified for BMI on IPSS, Qmax, or PVR in either unadjusted or adjusted model. Nonlinear test including BMI using RCS and adjusting for confounders showed no significance ( p > .05); however, a significant linear relationship was ascertained between BMI and the risk of larger PV ( p < .001). In conclusion, there was a significant linear association between BMI and the risk of larger PV in BPH patients. Hence, this suggests urologists should consider both BMI and PV when providing surgical treatment for BPH patients.

scholarly journals Efficacy and safety of Finasteride (5 alpha-reductase inhibitor) monotherapy in patients with benign prostatic hyperplasia: A critical review of the literature

2020 ◽  
Vol 91 (4) ◽  
pp. 205-210
Author(s):  
Gian Maria Busetto ◽  
Francesco Del Giudice ◽  
Daniele D'Agostino ◽  
Daniele Romagnoli ◽  
Andrea Minervini ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Benign Prostatic Hyperplasia ◽  
Adverse Events ◽  
Clinical Efficacy ◽  
Critical Review ◽  
Reductase Inhibitor ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Efficacy And Safety

Background: Combination therapy with 5 alpha-reductase inhibitor (5-ARI) and alpha-blocker can be considered as a gold standard intervention for medical management of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS/BPH). On the other hand, 5-ARI monotherapy and in particular Finasteride alone is currently getting focus of attention especially due to lack of systematic reviews investigating efficacy outcomes and/or adverse events associated. Objectives: Aim of the present critical review was to analyze current knowledge of clinical efficacy and incidence of adverse events associated with 5-ARI treatment for LUTS/BPH. Materials and methods: A systematic review of clinical trials of the literature of the past 20 years was performed using database from PubMed, Cochrane Collaboration and Embase. A total of 8821 patients were included in this study and inclusion criteria for studies selection were: data from randomized clinical trials (RCTs) focusing their attention on the clinical role of Finasteride monotherapy for symptomatic BPH. Parameters of research included prostate specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPPS), postvoid residual urine (PVR), voiding symptoms of IPSS (voiding IPSS), maximum urinary flow rate (Qmax), and adverse events (AEs). Results: Overall 12 original articles were included and critically evaluated. Sample sizes of patient actively treated with finasteride varied from 13 to 1524 cases analyzed in a single study. Follow-up after treatments ranged from 3 to 54 months. The effect of finasteride in reducing prostate volume (PV) was moderate (standardized mean difference (SMD) effect between 0.5 to 0.8 for all trials evaluable) while the effect on IPSS score and Qmax was considered significant (SMD in the 0.2 to 0.5 variation range). No severe AEs and/or psychiatric disorders were retrieved among the studies. Sexual health dysfunctions were significantly influenced by finasteride therapy when compared with placebo treated patients. Conclusions: Although significant clinical benefits of finasteride monotherapy were demonstrated, the effective size of the available reports included in the analysis is limited. Additional head-to-head studies would be needed to re-evaluate clinical efficacy and safety of 5-ARI in combination or not with alpha blockers.

Tamsulosin for the Treatment of Benign Prostatic Hypertrophy

2000 ◽  
Vol 34 (2) ◽  
pp. 188-199 ◽  
Author(s):  
Mary Lee
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Flow Rate ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Dosage Titration ◽  
Bladder Emptying ◽  
Voiding Symptoms ◽  
Adrenergic Antagonists

OBJECTIVE: To review the information necessary to assess the efficacy and safety of tamsulosin compared with other adrenergic antagonists for treatment of symptomatic benign prostatic hyperplasia. DATA SOURCES: A search was conducted of Cumulated Index Medicus, January 1993–August 1999, which was restricted to human trials and English-language journals. STUDYSELECTION AND DATAEXTRACTION: Efficacy studies were included if the design was randomized and included a control group. Drug safety was assessed using data from any patient series or controlled study. DATA SYNTHESIS: Tamsulosin, a uroselective α1A-adrenergic receptor antagonist, relaxes smooth muscle in the prostate and bladder neck, thereby enhancing bladder emptying. In randomized, controlled clinical trials using standardized instruments, tamsulosin improves obstructive voiding symptoms by at least 25% in 65–80% of patients with symptomatic benign prostatic hyperplasia. Tamsulosin also improves peak urinary flow rate by 1.4–3.6 mL/sec in various studies and reduces post-void residual urine volume. The usual dosage of tamsulosin was 0.4 or 0.8 mg orally once a day in the studies performed in the US and Europe; daily doses of 0.1–0.4 mg were used in studies performed in Japan. The beneficial effects of tamsulosin on voiding symptoms, peak urinary flow rate, and bladder emptying appear to be dose-related, up to a ceiling dose of 0.4 mg. The most common adverse effects are headache, asthenia, dizziness, and rhinitis-like complaints. Retrograde or delayed ejaculation occurs in 4.5–14.0% of patients and has required discontinuation of treatment in a minority of these patients. At the usual dose of 0.4–0.8 mg/d, tamsulosin does not appear to significantly reduce blood pressure, increase heart rate, or cause first-dose syncope; therefore, dosage titration is not necessary when initiating treatment. Use of nifedipine, enalapril, atenolol, furosemide, or digoxin does not require dosage modification when tamsulosin is initiated concomitantly; hypotension has not been reported with combined use of tamsulosin and these commonly used agents. CONCLUSIONS: Tamsulosin is an improvement over other a-adrenergic antagonists for the management of symptoms of benign prostatic hyperplasia. It is a more convenient alternative that does not require initial dosage titration, has a fast onset of action, and has a low potential to cause hypotension when used alone or in combination with commonly used antihypertensive agents. It is more costly than some of the other second-generation α-adrenergic antagonists.

scholarly journals Effects of Transurethral Resection of Prostate (TURP) on Quality of Life in Case of Benign Prostatic Hyperplasia

2019 ◽  
Vol 5 (2) ◽  
pp. 143-147
Author(s):  
Md Abul Hossain ◽  
Md Akter Alam ◽  
Md Fazal Naser ◽  
Md Shafiqul Azam
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Flow Rate ◽  
Transurethral Resection ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Transurethral Resection Of Prostate ◽  
Urinary Flow

Background: BPH is one of the most common cause of LUTS which significantly impairs the quality of life. TURP is minimally invasive surgical procedure for Benign Prostatic hyperplasia which has impact on quality of life. Impact on quality of life can be measured by QoL score and effect of TURP can be evaluated. Objective: The purpose of the present study was to evaluate the impact of transurethral resection of prostate (TURP) on Quality of Life (QoL) score. Methodology: This prospective study was carried out in the Department of Urology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, from July 2015 to June 2016. Total fifty patients between 50 to 72 years attending for the treatment of benign prostatic hypertrophy (BPH) with lower urinary tract symptoms (LUTS) were included for the study according to inclusion & exclusion criteria. All of them were evaluated with baseline international prostate symptoms score (IPSS), QoL score, peak urinary flow rate (Qmax), voided volume, voiding time and PVR and were recorded in a predesigned data sheet. Selected patients underwent Transurethral Resection of Prostate. They were followed after 1 month and 3 months with same parameter and compared with the baseline values. Results: The baseline international prostate symptoms score (IPSS) in this study was 25.18±1.45. At one month and three months follow up visits after TURP, the IPSS was decreased to 15.0±1.07 and 8.14±0.76 respectively. There was significant improvement of peak urinary flow rate (Qmax) in the postoperative period, at the 1st follow up visit after one month of TURP (15.78±1.42, p<0.001) and at the 2nd follow visit after three months of TURP (18.78, p <0.001). The mean QoL score was 5.30±0.46 before TURP. After one month of TURP it was 3.20±0.45 and after 3 months of TURP it was 1.86±0.57. Conclusion: There is a significant improvement of quality of after TURP. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 143-147

Frequency of Carcinoma Prostate in Patients with Clinically Diagnosed Benign Prostatic Hyperplasia (BPH) and Prostate Specific Antigen d" 4ng/ml

2020 ◽  
Vol 15 (2) ◽  
pp. 44-47
Author(s):  
Md Shafiqur Rahman ◽  
Sudip Das Gupta ◽  
Sajid Hasan ◽  
Prodyut Kumar Saha ◽  
Amanur Rasul ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Flow Rate ◽  
Histopathological Examination ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Transurethral Resection Of Prostate ◽  
Urinary Flow

Objectives: The present study was carried out in the Department of Urology, Sir Salimullah Medical College Mitford Hospital Dhaka between July 2009 to May 2010. To determine the frequency of prostate cancer in patients with BPH & PSA level d” 4 ngm/ml. Methods: A total of 198 subjects aged above 50 years with serum PSA level of not more than 4.0 ng per milliliter , no suspicious nodule on digital rectal examination , homogenous echogenicity of prostate on ultrasonographic findings, peak urinary flow rate (Qmax) < 10ml/sec in uroflowmetry and no clinically significant coexisting conditions were included in the study. All the patients presented with obstructive urinary symptoms attended at four tertiary hospitals in Dhaka city during the study period were evaluated with clinical history, physical examination and some investigations. All the patients were treated with transurethral resection of prostate (TURP). Chips were collected carefully and sent for histopathology. Results: The mean age was 65.1 ± 7.3 years. About 32% of patients had serum PSA level 2 ng/ml or less and 68.2% more than 2 ng/ml. The peak urinary flow rate was 7.2 ± 2.7 ml/sec. One hundred and ninety three (98%) patients were diagnosed as having benign prostatic hyperplasia (BPH) on histopathological examination and 5(2.5%) as having prostate carcinoma. Conclusion: Prostate cancer is not rare among men with PSA levels of 4.0 ng per milliliter or less Bangladesh Journal of Urology, Vol. 15, No. 2, July 2012 p.44-47

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