Kim Hyoung Woo, Moon Dae Geun, Kim Hyun Min, Hwang Jong Ho, Kim Soon Chan, Nam Sam Geuk, Park Jun Tag
Department of Urology, Sahmyook Medical Center, Seoul, Korea.
Korean J Urol. 2011 Oct;52(10):681-6. doi: 10.4111/kju.2011.52.10.681. Epub 2011 Oct 19.
Combination therapy of α-blockers and 5α-reductase inhibitors (5-ARIs) is widely used for the treatment of benign prostatic hyperplasia (BPH). We aimed to study the effect on prostate volume and symptoms of shifting to monotherapy in patients who previously received a combination therapy.
A prospective study was conducted of 60 patients who were diagnosed with BPH. Patients were aged 45 years or older and had a prostate volume of 30 cc or more, International Prostate Symptom Score (IPSS) of 12 or above, maximal flow rate (Qmax) of 15 ml/s or less, and prostate-specific antigen (PSA) level of less than 10 ng/ml. The patients initially received a combination therapy of doxazosin 4 mg/day and finasteride 5 mg/day for 3 months and were then randomly assigned to receive monotherapy for 3 months. The factors were then compared.
A total of 30 patients were assigned to doxazosin (group 1) and 30 to finasteride (group 2) after the combination therapy. The percentage changes in prostate volume, IPSS, and Qmax during the period from post-combination therapy to post-monotherapy were not significantly different between the two groups (p=0.052, 0.908, 0.081), whereas PSA significantly decreased in group 2 (p<0.001). IPSS was not significantly different at post-combination therapy and at post-monotherapy in both groups (p=0.858, 0.071). The prostate volume significantly increased from 40.97 cc at post-combination therapy to 44.29 cc at post-monotherapy in group 1 (p=0.001) and insignificantly increased from 38.32 cc to 38.61 cc in group 2 (p=0.696).
Although the duration of drug administration was short in this study, 5-ARI monotherapy could maintain the alleviated symptoms and reduce the risk of acute urinary retention and surgery due to prostate regrowth in BPH patients whose symptoms improved with combination therapy.
α受体阻滞剂与5α还原酶抑制剂（5-ARIs）联合治疗广泛用于良性前列腺增生（BPH）的治疗。我们旨在研究既往接受联合治疗的患者转为单一疗法对前列腺体积和症状的影响。
对60例诊断为BPH的患者进行了一项前瞻性研究。患者年龄在45岁及以上，前列腺体积为30立方厘米或更大，国际前列腺症状评分（IPSS）为12分或更高，最大尿流率（Qmax）为15毫升/秒或更低，前列腺特异性抗原（PSA）水平低于10纳克/毫升。患者最初接受多沙唑嗪4毫克/天和非那雄胺5毫克/天的联合治疗3个月，然后随机分配接受单一疗法治疗3个月。然后对各项因素进行比较。
联合治疗后，共有30例患者被分配接受多沙唑嗪治疗（第1组），30例接受非那雄胺治疗（第2组）。从联合治疗后到单一疗法治疗后期间，两组前列腺体积、IPSS和Qmax的百分比变化无显著差异（p = 0.052、0.908、0.081），而第2组PSA显著下降（p < 0.001）。两组联合治疗后和单一疗法治疗后的IPSS无显著差异（p = 0.858、0.071）。第1组前列腺体积从联合治疗后的40.97立方厘米显著增加到单一疗法治疗后的44.29立方厘米（p = 0.001），第2组从38.32立方厘米增加到38.61立方厘米，增加不显著（p = 0.
