THE IMPACT OF 5-ALPHA-REDUCTASE INHIBITORS ON THE NUMBER OF PROSTATECTOMIES FOR BENIGN PROSTATIC HYPERPLASIA

To determine the impact of a 5-alpha-reductase inhibitor on the need f or surgical treatment of symptomatic benign prostatic hyperplasia (BPH ) in clinical urologic practice, we retrospectively reviewed records o f 794 patients treated with pharmacotherapy or surgery (or both). The number of transurethral resections of the prostate (TURPs) performed d uring the 30 months since introduction of finasteride was compared wit h the number performed during 30 months before finasteride became avai lable. The alpha-blockers doxazosin and prazosin were used during both times For the treatment of BPH. Of the 619 patients treated with drug s, 88.5% received finasteride for a mean of 249.6 days. The alpha-bloc kers, either alone or combined with finasteride, were prescribed for 1 1.5% of patients for a mean of 179 days. In the 30 months after the in troduction of finasteride, 65 patients underwent TURF: 28 of these men had initially received drug therapy. In contrast, 138 TURPs were perf ormed in the 30 months prior to the availability of finasteride. The u se of a 5-alpha-reductase inhibitor as primary medical therapy for sym ptomatic BPH decreased the number of prostatectomies by 52.9% (65 vs 1 38). This observation warrants corroboration through additional prospe ctive studies.