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

ABSTRACT

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