Doxazosin versus finasteride for the treatment of large symptomatizing benign prostatic hyperplasia : a questionnaire and urodynamic-based study

Objectives: To evaluate and compare the efficacy of both Finasteride and Doxazosin in the treatment of moderately symptomatizing large-sized benign prostatic hyperplasia and to correlate symptomatic changes with alterations in urodynamic values using the OCO values (Schafer nomogram). Patients and Methods: Fifty male patients with moderately symptomatizing BPH ( 40 cc) as assessed by ultrasound; were randomized to receive either Finasteride (5 mg/day)or Doxazosin (1-4 mg/ day) for 12 months. Results: Both Finasteride and Doxazosin significantly improved the urinary flow rates. Pressure-flow studies confirmed that both Doxazosin and Finasteride were effective in decreasing the opening detrusor pressure; the detrusor pressure at maximum flow (PdetQmax) and the detrusor pressure at least flow (Pdet least). When applying the Schafer nomogram; the OCO values were found to have improved in both treatment groups. There was; however; a significant difference between both groups with respect to the OCO values denoting a better improvement of the degree of obstruction in patients treated with Finasteride. Conclusion: The use of a compatible numerical format for grading the degree of bladder outlet obstruction would maximize the usefulness of pressure-flow studies in the evaluation of obstructed patients. Using the OCO value revealed that Finasteride was superior to Doxazosin regarding the degree of improvement in obstruction caused by benign prostatic hyperplasia

Daxazosin in the treatment of elderly patients with benign prostatic hyperplasia

Objective To evaluate the efficacy and tolerability of doxazosin tablets in elderly patients with symptomatic benign prostatic hyperplasia (BPH). Patients and Methods This study involved the use of doxazosin; a once daily alpha-1 adrenergic blocker; for the treatment of BPH in two distinct phases. Phase 1 involved a two-week dose titration; escalating from 1 mg to 8 mg depending on response and tolerability using blood pressure (BP) and pulse as a monitor to arrive at a stabilizing dose. In phase 2; the patients were maintained on the stabilized dose for 6 weeks. The International Prostate Symptom Score (IPSS) and Quality of Life Assessment (QLA) were used to evaluate the severity of the illness and the response to treatment. Twenty-six patients were enlisted while only 20 met the criteria for analysis. Mean age was 72.5 (55-90) years. Eighteen (90) were stabilized at a doxazosin dose of 4 mg; while 2 (10) stabilized on 2 mg. Results There was a significant improvement of symptoms (IPSS) in all the patients at the end of the titration period; and this was progressive and sustained over the 6-week study period. QLA was also significantly improved. BP did not vary significantly in the normotensives; while the hypertensives required other antihypertensives to maintain normal levels. One case had severe postural hypotension that warranted discon-tinuation of the test drug. Using the Physician Global Assessment; efficacy was excellent in 65; good in 30and poor in 5; while tolerability was excellent in 95and poor in 5. Drug compliance was 100. Side effects were minimal and not life threatening. Conclusion Doxazosin is effective in the treatment of BPH in elderly Nigerians. It is compatible with other drugs used in the treatment of other illnesses associated with old age. It is therefore recommended for use in elderly BPH patients