| Androgen ablation and blockade in the treatment of benign prostatic hyperplasia. | |
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MedLine Citation:
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PMID: 1695786 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Antiandrogen therapy appears to produce a 30 to 40 per cent decrease in the volume of the hyperplastic prostate after 3 to 6 months of therapy (Table 5). Longer treatment may result in further prostatic regression, although this remains to be seen. Biopsy studies suggest that epithelial regression occurs to a much more significant degree than does stromal regression, but this finding may simply reflect the relatively longer turnover of the stromal cell population. The significant placebo effect of oral medication in patients with BPH makes interpretation of clinical symptomatology and uro-flow data difficult. Analysis of symptom improvement is further complicated by the relatively slow improvement of patients on antiandrogen therapy, in contrast to surgery, in which relief is immediate. In addition to limited stromal involution and inadequate treatment duration, other biologic factors may limit the clinical efficacy of antiandrogen therapy. Most importantly, prostatic involution may not necessarily decrease urethral resistance. In addition, obstruction-induced detrusor dysfunction may persist after relief of outflow obstruction in some patients, as it does after surgery. Incomplete antiandrogen action of the compounds, as well as compliance issues, may likewise limit efficacy. Although there are no data to suggest that the 5 alpha-reductase inhibitor finasteride will be more effective than other antiandrogen compounds in the treatment of BPH, preliminary studies suggest that it has less toxicity. If long-term studies validate a modest but significant clinical response rate and preservation of sexual function, then finasteride therapy may well be acceptable to a subgroup of men presenting with the symptoms of BPH.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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J D McConnell |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The Urologic clinics of North America Volume: 17 ISSN: 0094-0143 ISO Abbreviation: Urol. Clin. North Am. Publication Date: 1990 Aug |
Date Detail:
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Created Date: 1990-08-24 Completed Date: 1990-08-24 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0423221 Medline TA: Urol Clin North Am Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 661-70 Citation Subset: AIM; IM |
Affiliation:
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University of Texas Southwestern Medical Center, Dallas. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Androgen Antagonists
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therapeutic use* Androstenes / therapeutic use Azasteroids / therapeutic use Finasteride Flutamide / therapeutic use Humans Luteinizing Hormone / physiology Male Orchiectomy Prostatic Hyperplasia / drug therapy*, surgery Testosterone 5-alpha-Reductase / antagonists & inhibitors |
| Chemical | |
Reg. No./Substance:
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0/Androgen Antagonists; 0/Androstenes; 0/Azasteroids; 13311-84-7/Flutamide; 9002-67-9/Luteinizing Hormone; 98319-26-7/Finasteride; EC 1.3.99.5/Testosterone 5-alpha-Reductase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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