Inamura So, Fukiage Yusuke, Kobayashi Hisato, Tsutsumiuchi Manami, Seki Masaya, Taga Minekatsu, Fukushima Masato, Kobayashi Motohiro, Yokoyama Osamu, Terada Naoki
Department of Urology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
Int J Urol. 2025 Feb;32(2):151-157. doi: 10.1111/iju.15612. Epub 2024 Oct 23.
α-1 blockers and dutasteride are widely used as agents to treat benign prostatic hyperplasia (BPH); the impact of these drugs on prostatic inflammation is still unclear. Herein, we investigated the impact of α-1 blockers and dutasteride treatment of BPH in terms of the degree of prostatic inflammation.
Tissue specimens were obtained from 143 BPH patients who were administered α-1 blockers up until their operation. Thirty-three of the patients had also been treated with dutasteride before the procedure. The degree of prostatic inflammation was quantified histologically by the ratio of high endothelial venule (HEV)-like vessels. We divided this retrospective cohort into α-1 blocker monotherapy and combination therapy (α-1 blockers + dutasteride) groups and evaluated clinical parameters of the two groups in relation to the degree of chronic prostatic inflammation. At the same time, we assessed factors exacerbating chronic prostatic inflammation.
Comparison of the monotherapy and combination therapy groups showed no significant differences in the parameters of the urodynamic study or degree of chronic prostatic inflammation, whereas the IPSS total score, voiding subscore, nocturia, intermittency, weak stream, and straining were significantly lower in the combination than the monotherapy group. The duration of α-1 blockers administration was not correlated with the ratio of HEV-like vessels, while that of dutasteride was strongly correlated (correlation coefficient = 0.595; p < 0.001). Multiple regression analysis demonstrated that the duration of dutasteride administration was a key factor exacerbating the degree of chronic prostatic inflammation.
The present study showed that despite their ameliorating effect on prostatic hyperplasia, dutasteride contributed significantly to chronic prostatic inflammation.
α-1受体阻滞剂和度他雄胺被广泛用作治疗良性前列腺增生（BPH）的药物；这些药物对前列腺炎症的影响仍不清楚。在此，我们从前列腺炎症程度方面研究了α-1受体阻滞剂和度他雄胺治疗BPH的影响。
组织标本取自143例术前一直服用α-1受体阻滞剂的BPH患者。其中33例患者在手术前还接受过度他雄胺治疗。通过高内皮微静脉（HEV）样血管的比例对前列腺炎症程度进行组织学定量。我们将这个回顾性队列分为α-1受体阻滞剂单药治疗组和联合治疗组（α-1受体阻滞剂 + 度他雄胺），并评估两组与慢性前列腺炎症程度相关的临床参数。同时，我们评估了加重慢性前列腺炎症的因素。
单药治疗组和联合治疗组的尿动力学研究参数或慢性前列腺炎症程度比较无显著差异，而联合治疗组的国际前列腺症状评分（IPSS）总分、排尿子评分、夜尿、尿流中断、尿流无力和排尿费力均显著低于单药治疗组。α-1受体阻滞剂的用药时长与HEV样血管比例无关，而度他雄胺的用药时长与之呈强相关（相关系数 = 0.595；p < 0.001）。多元回归分析表明，度他雄胺的用药时长是加重慢性前列腺炎症程度的关键因素。
本研究表明，尽管度他雄胺对前列腺增生有改善作用，但它对慢性前列腺炎症有显著影响。
