HEMATURIA ASSOCIATED WITH BPH - NATURAL-HISTORY AND A NEW TREATMENT OPTION

Bleeding of prostatic origin is usually caused by the friable hypervas cularity of the prostate, the vessels of which are easily disrupted by physical activity. The condition is often ignored after the patient h as been fully investigated and more serious causes for bleeding exclud ed and treatment is often withheld unless the bleeding becomes excessi ve. We analysed the clinical effect of finasteride in the treatment of this condition. We retrospectively reviewed 42 patients diagnosed as having haematuria secondary to bleeding from a benign prostate. Eighte en patients were simply reassured and given no treatment. Twenty-four patients with prostatic bleeding were treated using finasteride. All c ase notes were reviewed and the patients were contacted by telephone. Of 18 patients who had prostatic bleeding but did not receive treatmen t the mean age was 70 y and the mean follow-up was 10 months; two had died, nine had no further bleeding, two had a single episode of bleedi ng requiring no treatment, six had several bleeding episodes of whom o ne started finasteride, one refused treatment, and three required TURF . In the group treated with finasteride the mean follow up was 9 month s, the mean age of the patients was 75 y. Twenty patients had no furth er bleeding, one patient experienced minor intermittent bleed and requ ired no further treatment. Two patients died of non-urological causes, one patient stopped the treatment because of impotence and one patien t had mild gynecomastia. Haematuria secondary to prostatic bleeding ca n be significant if not treated. Finasteride appears to be effective i n suppressing haematuria caused by benign prostatic hyperplasia and sh ould be considered in treating this problem.