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Hormonal manipulation of benign prostatic hyperplasia.
MedLine Citation:
PMID:  23202285     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: We provide new viewpoints of hormonal control of benign prostatic hyperplasia (BPH). The latest treatment findings with 5-alpha reductase inhibitors (5-ARIs) finasteride and dutasteride, refined indications, efficacy, and safety are discussed and compared. We also discuss potential new 5-ARIs and other hormonal treatments.
RECENT FINDINGS: Finasteride and dutasteride have equal efficacy and safety for the treatment and prevention of progression of BPH. 5-ARIs are especially recommended for prostates greater than 40 ml and PSA greater than 1.5 ng/ml. Combination therapy is the treatment of choice in these patients, but with prostate volume greater than 58 ml or International Prostate Symptom Score of at least 20, combinations have no advantage over 5-ARI monotherapy. Updates on the recent developments on BPH therapy with luteinizing hormone-releasing hormone (LHRH) antagonist are also reviewed and analyzed. Preclinical studies suggest that growth hormone-releasing hormone (GHRH) antagonists effectively shrink experimentally enlarged prostates alone or in combination with LHRH antagonists.
SUMMARY: New 5-ARIs seem to be the promising agents that need further study. Preclinical studies revealed that GHRH and LHRH antagonists both can cause a reduction in prostate volume. Recent data indicate that prostate shrinkage is induced by the direct inhibitory action of GHRH and of LHRH antagonists exerted through prostatic receptors. The adverse effects of 5ARIs encourage alternative therapy.
Authors:
Ferenc G Rick; Seyed H Saadat; Luca Szalontay; Norman L Block; Amir Kazzazi; Bob Djavan; Andrew V Schally
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in urology     Volume:  23     ISSN:  1473-6586     ISO Abbreviation:  Curr Opin Urol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200621     Medline TA:  Curr Opin Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-24     Citation Subset:  IM    
Affiliation:
aVeterans Affairs Medical Center, South Florida Veterans Affairs Foundation for Research and Education bDepartment of Pathology, University of Miami, Miller School of Medicine, Miami, Florida cDepartment of Urology, New York University School of Medicine, NYU, New York, New York dDivision of Hematology/Oncology eDivision of Endocrinology, Department of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA.
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