BPH Patients Should Be Assessed Before Dutasteride Therapy

BPH Patients Should Be Assessed Before Dutasteride Therapy

Researchers at the Keio University School of Medicine in Japan suggest that regular assessments of erectile function in patients with benign prostatic hyperplasia (BPH) should be required before the administration of dutasteride, especially in younger patients and those with greater levels of EF.

Their study, “A prospective longitudinal survey of erectile function status in symptomatic benign prostatic hyperplasia patients treated with dutasteride,” was published in The Aging Male journal.

BPH, characterized by an increase in prostate size, is often associated with lower urinary tract symptoms (LUTS) and a decrease in sexual function, which have a negative impact on the quality of life. To relieve the symptoms and improve the quality of life, two main classes of medicines are currently available on the market: alpha blockers and 5- alpha reductase inhibitors.

The treatment of BPH patients using 5- alpha reductase inhibitors (5ARI) such as dutasteride (DUT) has been shown to improve a number of issues, including prevention of BPH from progression, reduction in prostate size, lower risk of urinary retention, and a decline in BPH-related surgery. For these reasons, 5ARI is recommended by The American Urological Association and European Association of Urology guidelines, particularly for patients with severe BPH.

One of the adverse effects of DUT reported in clinical trials is reduced erectile function (EF). To confirm these findings, researchers examined EF in 98 patients treated with 0.5 mg DUT followed for more than 12 months between 2009 and 2012. The evaluation was performed using a number of parameters: Sexual Health Inventory for Men (SHIM), erectile hardness score (EHS), International Prostate Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS), before and at 3, 6, and 12 months.

The results showed significant improvements in the IPSS and OABSS parameters. Significant improvements were observed in IPSS and OABSS in 98 patients with the DUT treatment, and the effects were similar between 28 patients with potency with baseline SHIM of 8 or greater and 70 severe erectile dysfunction (ED) patients at baseline. The 28 patients with potency illustrated a significant reduction in SHIM and EHS after 3, 6, and 12 months of treatment with DUT.

After 12 months, half of the 28 patients with potency experienced severe deterioration in ED, according to SHIM. Among them, eighteen (64.3 percent) with potency at baseline were younger with higher SHIM and EHS just before the treatment and had experienced ED before DUT treatment.

“The daily administration of DUT not only resulted in an improved urinary status, but also deteriorated EF, especially in BPH patients with potency before the treatment. Regular assessments of the occurrence of ED due to DUT are needed, especially in younger patients and those having higher levels of EF before the administration of DUT,” the authors concluded.

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