Long-Term Treatment With Finasteride Results in a Clinically Significant Reduction in Total Prostate Volume Compared to Placebo Over the Full Range of Baseline Prostate Sizes in Men Enrolled in the MTOPS Trial

Kaplan, Steven A.; Roehrborn, Claus G.; McConnell, John D.; Meehan, Alan G.; Surynawanshi, Shailaja; Lee, Jeannette; Rotonda, J.; Kusek, John W.; Nyberg, Leroy M.

doi:10.1016/j.juro.2008.05.004

Cited by 58 publications

(50 citation statements)

References 3 publications

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“…22 Therefore, the progressive reduction of PV known to occur with 5ARI treatment may result in alleviation of BOO. 23 We hypothesize that it is the alleviation of the mechanical stress caused by BOO that then allows reversal of structural and functional changes in the bladder, thus leading to improvements in storage symptoms with a 5ARI of comparable magnitude to an a-blocker after 15 months of therapy.…”

Section: Discussionmentioning

confidence: 99%

The effects of dutasteride, tamsulosin, and the combination on storage and voiding in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the Combination of Avodart and Tamsulosin study

Becher

Roehrborn²,

Siami³

et al. 2009

Prostate Cancer Prostatic Dis

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This article reports the results of a post hoc analysis of the multicenter, randomized, double-blind Combination of Avodart and Tamsulosin (CombAT) study, which aimed to investigate the effects of dutasteride (0.5 mg), tamsulosin (0.4 mg), and their combination on storage and voiding symptoms in 4844 men aged X50 years with moderate-to-severe lower urinary tract symptoms (International Prostate Symptom Score X12), prostate volume (PV) X30 cm 3 and PSA 1.5-10 ng ml À1. After 24 months, combination treatment achieved significantly greater mean reductions in both voiding and storage symptoms than either monotherapy, in each of the three baseline PV tertiles (30 to o42, 42 to o58, X58 cm 3 ). Dutasteride was as effective as tamsulosin for control of storage symptoms, but provided significantly greater relief of voiding symptoms than tamsulosin.

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Section: Discussionmentioning

confidence: 99%

The effects of dutasteride, tamsulosin, and the combination on storage and voiding in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the Combination of Avodart and Tamsulosin study

Becher

Roehrborn²,

Siami³

et al. 2009

Prostate Cancer Prostatic Dis

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“…Studies using TRUS found that 5ARIs reduce total prostate volume by 17%-46% and transition zone volume by 7%-25% within the first year of therapy (10)(11)(12). While total prostate volume and transition zone volume dynamics in response to 5ARIs are widely accepted, there have been conflicting reports regarding the effects of 5ARIs on peripheral zone volume.…”

Section: Role Of Prostatic Volume Determination In Bph Managementmentioning

confidence: 99%

Clinical value of prostate segmentation and volume determination on MRI in benign prostatic hyperplasia

Garvey¹,

Türkbey²,

Truong³

et al. 2014

Diagn Interv Radiol

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Benign prostatic hyperplasia (BPH) is a nonmalignant pathological enlargement of the prostate, which occurs primarily in the transitional zone. BPH is highly prevalent and is a major cause of lower urinary tract symptoms in aging males, although there is no direct relationship between prostate volume and symptom severity. The progression of BPH can be quantified by measuring the volumes of the whole prostate and its zones, based on image segmentation on magnetic resonance imaging. Prostate volume determination via segmentation is a useful measure for patients undergoing therapy for BPH. However, prostate segmentation is not widely used due to the excessive time required for even experts to manually map the margins of the prostate. Here, we review and compare new methods of prostate volume segmentation using both manual and automated methods, including the ellipsoid formula, manual planimetry, and semiautomated and fully automated segmentation approaches. We highlight the utility of prostate segmentation in the clinical context of assessing BPH. Benign prostatic hyperplasia (BPH) can result in lower urinary tract symptoms, and is one of the most common diseases affecting aging men. BPH can compromise quality of life and is a major healthcare cost. Despite the high prevalence of BPH, few methods of accurately assessing prostate volume are actually used in clinical practice. While patient assessment of urinary symptoms dictates the need for treatment, it is highly subjective, whereas prostate volume change is a more objective measure of treatment response. The most common clinical model for approximating the prostate gland size is the ellipsoid model from transrectal ultrasonography (TRUS) imaging, which has been shown to underestimate prostate volume for prostates larger than 50 mL and to overestimate prostate volume for glands smaller than 30 mL (1). Despite its limitations, the TRUS method of prostate volume assessment is preferred in current clinical practice due to its availability and cost and time efficiency (2). More accurate prostate volume measurement with magnetic resonance (MR) planimetry is time-intensive and, thus, rarely performed.Prostate segmentation is an accurate technique for prostate volume determination that can be used in coregistration with various imaging modalities, such as magnetic resonance imaging (MRI) with positron emission tomography and MRI with ultrasonography. Segmentation can be used for both diagnostic and interventional procedures, including guided biopsies and focal ablation. Newly developed methods of automated prostate segmentation allow for efficient prostate volume determination, thereby enhancing decision support systems and computer-aided diagnosis tools.This article reviews the major methods of prostate volume determination currently in use, including the ellipsoid formula, manual planimetry, and semiautomated and fully automated segmentation. A clinical overview of BPH is also provided to highlight the utility of prostate segmentation in the clinical management...

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“…Further secondary analysis suggested that the addition of finasteride was more effective in men with larger (>40 cm 3 ) prostates, as found in the PLESS, but the PREDICT trial was not designed to take this parameter into account [14]. Analysis of the longer MTOPS trial concluded that finasteride alone or in combination with doxazosin consistently resulted in clinically significant TPV reduction regardless of baseline prostate size [19][20][21]. There is still some debate as to the value of using combination therapy and adding a 5ARI in patients with smaller prostates, as opposed to the use of an alpha-blocker alone.…”

Section: Aris In the Treatment Of Bphmentioning

confidence: 99%

Steroid 5 α-reductase inhibitors targeting BPH and prostate cancer

Schmidt

Tindall

2011

The Journal of Steroid Biochemistry and Molecular Biology

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Long-Term Treatment With Finasteride Results in a Clinically Significant Reduction in Total Prostate Volume Compared to Placebo Over the Full Range of Baseline Prostate Sizes in Men Enrolled in the MTOPS Trial

Cited by 58 publications

References 3 publications

The effects of dutasteride, tamsulosin, and the combination on storage and voiding in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the Combination of Avodart and Tamsulosin study

The effects of dutasteride, tamsulosin, and the combination on storage and voiding in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the Combination of Avodart and Tamsulosin study

Clinical value of prostate segmentation and volume determination on MRI in benign prostatic hyperplasia

Steroid 5 α-reductase inhibitors targeting BPH and prostate cancer

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