[Medical treatment of benign prostatic hyperplasia. The efficacy of finasteride depends on prostatic volume].

OBJECTIVE: To demonstrate that the efficacy of finasteride in benign prostatic hyperplasia (BPH) depends on the prostate volume. METHODS: 75 patients with BPH were classified according to the prostate volume: 20-40 Gm (group I), 40-80 Gm (group II) and more than 80 Gm (group III). The average duration of treatment for all three groups was 16.2 months. Patients were evaluated for symptom score (I-PSS), quality of life, prostate volume by ultrasound, maximum urinary flow rate, residual urine, plasma PSA and testosterone levels. RESULTS: Ultrasound demonstrated a reduction in prostatic volume of 6.8-14.8 Gm. Symptom score was reduced by 9.2-15.5 points and quality of life 2-2.7 points. Maximum urinary flow rate increased 3.4-4.4 ml/sec and residual urine decreased in all three groups. Testosterone values showed no significant changes. PSA values showed a reduction of 1.3-1.7 ng/ml. CONCLUSIONS: The efficacy of finasteride depends on the prostatic volume. Medical treatment is a temporary alternative to surgery due to its cost and because patients are unaccustomed to having to take a tablet daily.