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Hormonal treatment of patients with benign prostatic hyperplasia: Pros and cons

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Abstract

The recognition that dihydrotestosterone is a “major player” in the development of benign prostatic hyperplasia (BPH) provided an impetus for the development of a 5a-reductase inhibitor, finasteride. During the past 5 years, a number of publications have noted that alpha blockers appear more efficacious than finasteride. This article reviews the role of hormones (particularly finasteride) in the treatment of lower urinary tract symptoms caused by BPH. These observations indicate that finasteride has a role in the management of larger prostates. Long-term use reduces the development of urinary retention and need for invasive procedures such as transurethral prostatectomy. The major adverse impact of finasteride is its effect on the patient’s libido and sexual function. This is a less morbid problem for the elderly than the potential syncope associated with the use of alpha blockers. A greater understanding of the interaction of hormones on prostate receptors will provide newer tools for the treatment of BPH.

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Authors and Affiliations

  1. Division of Urology, Maimonides Medical Center, 4802 Tenth Avenue, 11219, Brooklyn, NY, USA

    Gilbert J. Wise MD & Edward Ostad MD

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  1. Gilbert J. Wise MD
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  2. Edward Ostad MD
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Wise, G.J., Ostad, E. Hormonal treatment of patients with benign prostatic hyperplasia: Pros and cons. Curr Urol Rep 2, 285–291 (2001). https://doi.org/10.1007/s11934-001-0065-1

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  • DOI: https://doi.org/10.1007/s11934-001-0065-1

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