Key result
Dutasteride improves IPSS across BPH sizes but shows limited effectiveness in the small BPH group.
Why the study?
Only a few reports have studied the efficacy of dutasteride in patients with small benign prostatic hyperplasia (BPH).
Does dutasteride improve lower urinary tract symptoms in patients with small versus large BPH?
Cohort (n=81)
Does dutasteride improve lower urinary tract symptoms in patients with small versus large BPH?
Dutasteride improves lower urinary tract symptoms in patients with both small and large BPH, though its effectiveness is more limited in those with small BPH (prostate volume < 30 mL).
Should not yet alter BPH management for small prostates; leaves open need for RCTs to confirm differential efficacy.
Background: Only a few reports have currently studied the efficacy of dutasteride in patients with small benign prostatic hyperplasia (BPH). We investigated the efficacy of dutasteride on reducing lower urinary tract symptoms among them. Materials and methods: A total of 81 patients with BPH who completed 52weeks of 0.5?mg dutasteride treatment were enrolled. Each patient filled out the International Prostatic Symptom Score (IPSS) and overactive bladder symptom score (OABSS) at baseline and at the 6- and 12-month follow-up visits. Total testosterone, prostate-specific antigen, adenoma/prostate volume (PV), uroflowmetry analysis, and postvoid residual volume were evaluated at baseline and at the 12-month follow-up visit. The enrolled patients were divided into 2 groups according to PV at baseline. The groups were as follows: Group A (PV ≥ 30 mL) and Group B (PV < 30 mL). Results: Groups A and B had mean PVs of 52.1 and 23.6 mL and mean IPSS scores of 16.7 and 14.4, respectively. Group A had significantly higher OABSS and prostate-specific antigen levels at baseline than Group B, while no significant differences in any other baseline characteristics was observed. After dutasteride treatment, adenoma volume and PV decreased significantly, while testosterone level showed a significant increase in both groups. Group A showed significant improvements in the total IPSS, voiding and storage subscore of the IPSS, OABSS, maximum flow rate, and postvoid residual volume. Group B, on the other hand, also showed significant improvements only in the total IPSS, voiding subscore of the IPSS, and maximum flow rate. Conclusions: The present study suggests a possible beneficial effect of dutasteride treatment on the reduction of lower urinary tract symptoms in patients with small and large BPH. However, the effectiveness of dutasteride was limited compared to patients with large BPH (PV ≥ 30 mL).
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Shigehara et al. (2022) conducted a cohort in Benign prostatic hyperplasia (n=81). Dutasteride vs. Small BPH (PV < 30 mL) was evaluated on Lower urinary tract symptoms (IPSS, OABSS, uroflowmetry). Dutasteride 0.5 mg for 52 weeks improved IPSS in both large (mean PV 52.1 mL) and small (mean PV 23.6 mL) BPH groups, though effectiveness was limited in the small BPH group.
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