Effect of Finasteride According to the Histological Types of Benign Prostatic Hyperplasia as Predicted by Transrectal Ultrasonography

Lee, Jeong Kee; Kim, Tae Hyo; Shim, Hong Bang

Abstract

PURPOSE: Finasteride is being used as a medical therapy of benign prostatic hyperplasia (BPH), but there are no appropriate selection criteria for finasteride therapy. Our objective was to determine the usefulness of finasteride according to histological nature of the BPH, as determined by the transrectal ultrasonography (TRUS) findings.
MATERIALS AND METHODS
Forty-two patients with symptomatic BPH were treated with finasteride (5mg/day) for more than 6 months. The patients were categorized into two groups of 21, according to their TRUS findings: the stromal, and the glandular, component dominant groups. The changes in prostate volume (PV), transition zone volume (TZV) and transition zone index (TZI) of each group, following at least 6 months of finasteride treatment, were evaluated and compared.
RESULTS
In the stromal group the PV, TZV and TZI decreased from 69.3 11.5cc to 65.6 9.3cc, 43.5 13.2cc to 40.8 8.8cc and 0.63 to 0.62, respectively, but these changes were not statistically significant. While, in the glandular group, the PV, TZV and TZI decreased from 67.4+/-26.7cc to 56.2+/-25.2cc, 43.9+/-24.9cc to 32.4+/-19.9cc, and 0.63 to 0.54 (P<0.05), respectively. There was a linear correlation, only in the glandular group, between the TZI and TZV reductions following finasteride therapy (R=0.47, p=0.009).
CONCLUSIONS
We suggest the prediction of the histological nature of BPH, by TRUS, would be helpful prior to the initiation finasteride treatment for effective reduction in the prostate volume with BPH. The effective reduction in the volume of the prostate in BPH would be possible only in glandular component dominant patients, as discriminated by TRUS.