scholarly journals Efficacy and Safety of Silodosin and Dutasteride Combination Therapy in Acute Urinary Retention due to Benign Prostatic Hyperplasia: A Single-Arm Prospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kazuhisa Hagiwara ◽  
Takuya Koie ◽  
Hiromichi Iwamura ◽  
Atsushi Imai ◽  
Shingo Hatakeyama ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Prostatic Hyperplasia ◽  
First Episode ◽  
Urinary Flow ◽  
Daily Trial ◽  
Postvoid Residual Urine

This study aimed to assess the efficacy of combination therapy with dutasteride and silodosin in patients with acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH). Eighty consecutive patients with a first episode of AUR were enrolled in this study. All patients received silodosin 8 mg and dutasteride 0.5 mg daily. Trial without catheter (TWOC) was attempted every 2 weeks until 12 weeks after the initiation of medication. The primary endpoint was the rate of catheter-free status at 12 weeks. Voided volume (VV), postvoid residual urine (PVR), uroflowmetry, International Prostatic Symptoms Score (IPSS), and quality of life due to urinary symptoms (IPSS-QOL) were also measured. All patients were followed up for more than 12 weeks and were included in this analysis. The success rate of TWOC at 12 weeks was 88.8%. VV and maximum urinary flow rate were significantly higher at 2, 4, 8, and 12 weeks compared with the time of AUR (P<0.001). IPSS and IPSS-QOL were significantly lower at 2, 4, 8, and 12 weeks compared with the time of AUR (P<0.001). In conclusion, a combination of dutasteride and silodosin therapy may be effective and safe for patients with AUR due to BPH.

scholarly journals Monotherapy versus combination therapy in the treatment of benign prostatic hyperplasia: A single center study

2020 ◽  
Vol 24 (3) ◽  
pp. 333-337
Author(s):  
Wishyar Al-Bazzaz ◽  
Omar Alkhayat ◽  
Ali AlKhayat
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Urinary Retention ◽  
Prostate Specific Antigen ◽  
Acute Urinary Retention ◽  
Prostate Volume ◽  
Combined Treatment ◽  
Specific Antigen ◽  
Prostatic Hyperplasia ◽  
Once Daily

Background and objectives: Most benign prostatic hyperplasia patients do not present obvious indicators for surgical intervention, so most of these patients are treated initially with medical therapy. This study aimed to compare the incidence of acute urinary retention after treatment with monotherapy with the incidence after combination therapy and determine the need for surgery in both methods. Methods: This is a retrospective study of the medical records of 248 benign prostatic hyperplasia patients who had attended Rizgary Teaching Hospital from May 2012 to June 2017. These patients were divided into two groups of 138 and 110 patients who have been treated by 0.4 mg tamsulosin capsule once daily and 0.4 mg tamsulosin capsule plus 5mg finasteride tablet once daily, respectively. Benign prostatic hyperplasia outcomes (acute urinary retention, benign prostatic hyperplasia related surgery) were compared between these two groups according to prostate volume and serum prostate specific antigen. Results: The combined treatment had significantly reduced the incidence of acute urinary retention and benign prostatic hyperplasia related surgery than monotherapy (P = 0.006 and 0.044, respectively). Similarly, when prostate volume and prostate specific antigen were above the cutoff value, both acute urinary retention and benign prostatic hyperplasia related surgery were lower in the combination therapy group than the monotherapy group. Conclusion: Combined therapy (0.4 mg tamsulosin plus 5mg finasteride) was significantly superior to 0.4 mg tamsulosin alone in the reduction of the incidence of acute urinary retention and benign prostatic hyperplasia related surgery among benign prostatic hyperplasia patients. Keywords: Benign prostatic hyperplasia; Acute urinary retention; Benign prostatic hyperplasia related surgery; Prostate volume; Prostate specific antigen.

scholarly journals Symptomatic benign prostatic hyperplasia: the role of 5-alpha-reductase inhibitors in the prevention of acute urinary retention and surgical therapy

2012 ◽  
pp. 57-62
Author(s):  
Norma Marigliano ◽  
Domenico Galasso
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Urinary Retention ◽  
Surgical Therapy ◽  
Acute Urinary Retention ◽  
Prostatic Hyperplasia ◽  
Complete Suppression ◽  
Urinary Flow ◽  
Reductase Inhibitors ◽  
5 Alpha Reductase Inhibitors

Benign prostatic hyperplasia (BPH) is a disease that affects over 50% of males aged 50 years or older. In men aged >80 years, the incidence is 90%. BPH occurs in 9-25% of males aged 40 to 79 years. Fifty percent of patients with BPH are symptomatic. The symptoms include reduced urinary flow, nocturia, defective bladder emptying, urinary hesitancy, and dysuria. Disease progression can be associated with acute urinary retention (AUR). Prostatic obstruction includes mechanical and dynamic components, the latter mediated by alpha-muscarinic receptors. Treatment with alpha-1-blockers (alfuzosin, doxazosin, tamsulosin, and terazosin) leads to rapid amelioration of symptoms and urinary flow, usually within one or two weeks. The 5-alpha reductase inhibitors (5-ARIs) are “disease-modifying drugs.” They control the growth of the prostate by blocking the conversion of testosterone into dihydrotestosterone (DHT). Finasteride is a 5–ARI that is selective for type 2 receptors. Dutasteride is a powerful inhibitor of both 5- alpha reductase isoforms (type 1 and 2) and produces more complete suppression of DHT synthesis than finasteride. Dutasteride also has a much longer half-life than finasteride (five weeks versus five to six hours). The authors review the results of clinical trials involving finasteride and dutasteride, with and without alpha-1-blockers, highlighting the important role of dutasteride in improving acute urinary retention and eliminating the need for surgical therapy.

scholarly journals Clinical Significance of Intravesical Prostatic Protrusion Index in Patients with Clinical Diagnosis of Benign Prostatic Hyperplasia. 

2021 ◽  
Author(s):  
Seyed Reza Yahyazadeh ◽  
Seyed Shahaboddin Izadi
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
International Prostate Symptom Score ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Postvoid Residual Urine ◽  
Intravesical Prostatic Protrusion ◽  
Maximum Urinary Flow

Abstract Purpose: To investigate the clinical significance of the intravesical prostatic protrusion (IPP) index in benign prostatic hyperplasia (BPH) patients to clarify its diagnostic value in predicting the clinical and structural abnormalities of the prostate. Materials and Methods: In this descriptive and analytical cross-sectional study, we include every man older than 50 years old with lower urinary tract symptoms (LUTS), predominantly voiding or obstructive, suggestive of BPH. The patients were evaluated to determine the following indices: IPSS (International Prostate Symptom Score) Index, QoL (quality of life), prostate volume (PV) and postvoid residual urine (PVR), serum PSA level, and the maximum urinary flow rate (Qmax) obtained by uroflowmetry. Subsequently, the assessment of the IPP index was undertaken by transabdominal ultrasonography. The categorization of the IPP index was done into 3 grades: grade one (below 5 mm), grade two (between 5 and 10 mm), and grade three (greater than 10 mm). Results: The significant direct correlation between the intravesical prostatic protrusion and international prostate symptom score, quality of life, prostate volume, postvoid residual urine, and serum PSA as well as inversely with the maximum urinary flow rate was confirmed both before and after the medical treatment. Also, the need for surgical intervention increased significantly with increasing IPP levels. Conclusion: The intravesical prostatic protrusion can be used to evaluate and predict the severity of symptoms and outcomes in patients with clinical BPH.

scholarly journals Comparison of α-Blocker Monotherapy and α-Blocker plus 5α-Reductase Inhibitor Combination Therapy Based on Prostate Volume for Treatment of Benign Prostatic Hyperplasia

2012 ◽  
Vol 40 (3) ◽  
pp. 899-908 ◽  
Author(s):  
K-J Joo ◽  
W-S Sung ◽  
S-H Park ◽  
W-J Yang ◽  
T-H Kim
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Reductase Inhibitor ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Urine Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Volume Transition ◽  
Postvoid Residual Urine

OBJECTIVE: This study compared α-blocker monotherapy with combination therapy involving an α-blocker and a 5-α reductase inhibitor for benign prostatic hyperplasia (BPH), according to baseline prostate volume. METHODS: Korean men diagnosed with BPH were randomized to 12 months' treatment with 0.2 mg tamsulosin or 0.2 mg tamsulosin plus 0.5 mg dutasteride. Prostate specific antigen (PSA), prostate volume, transition zone volume (TZV), International Prostate Symptom Score (IPSS), maximal urinary flow rate ( Qmax), postvoid residual urine volume and sexual function were assessed at baseline and after 12 months' treatment. Variables were analysed based on baseline prostate volumes of ≤ 35 ml or > 35 ml. RESULTS: In total, 216 men with BPH were included. Combination therapy resulted in significant improvements in prostate volume, TZV, PSA, IPSS and Qmax, which were most pronounced in men with a prostate volume > 35 ml. CONCLUSIONS: Tamsulosin monotherapy was sufficient treatment for BPH in Korean men with a prostate volume ≤ 35 ml. Combination tamsulosin and dutasteride therapy provided greater benefits than tamsulosin monotherapy in men with BPH whose prostate volume was > 35 ml.

MODELING AN APPROACH TO THE TREATMENT OF ACUTE URINARY RETENTION IN BENIGN PROSTATIC HYPERPLASIA

2020 ◽  
Vol 22 (4) ◽  
pp. 82-87
Author(s):  
S.M. Pikalov ◽  
A.A. Zimichev ◽  
D.O. Gusev ◽  
P.V. Sumsky ◽  
A.D. Adilov ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Prostatic Hyperplasia
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