Effects of the chronic use of finasteride and doxazosin mesylate on the histomorphometric characteristics of the prostate: experimental study in rats.

OBJECTIVE: The objective of the present study is to evaluate the histomorphometric characteristics of the prostate of rats submitted to chronic (long-time) treatment with doxazosin mesylate, finasteride and both substances combined. MATERIALS AND METHODS: Four groups of eight rats each were selected for this study and treated with saline solution (control), doxazosin mesylate, finasteride and combination of the drugs, during 10 months. After this time, the prostate was removed, weighed and sent for histological analysis. Prostate sections were stained with Masson trichrome. With an image analyzer, the percentage of smooth muscle, collagen, epithelium, acinar lumen and interstitial space was measured. Also, the minimum, medium and maximum epithelial thickness, number of acini per field, mean acinar area and the presence of papillary projections were evaluated. RESULTS: The mean prostate weight of rats treated with finasteride and combined treatment was lower when compared to the control group (P < 0.05). Prostate from rats treated with finasteride alone had a lower percentage of the epithelial component and a smaller minimum epithelial thickness than the control group (P < 0.05). The number of acini per field in the combined groups was higher than that observed in all other groups (P < 0.05). Also, rats of the finasteride and combined groups presented a reduced number of papillary projections when compared to the other groups (P < 0.05). CONCLUSION: Our study clearly showed the effects of finasteride on prostate tissue, and from a histomorphometric perspective, it was not able to detect any advantage of the combined treatment over the use of finasteride alone.

Diabetes mellitus is associated with subnormal serum levels of free testosterone in men.

OBJECTIVE: To evaluate the relationship between diabetes mellitus (DM) and serum levels of free (FT) and total (TT) testosterone. PATIENTS AND METHODS: A cross-sectional study was carried out including 746 men, of whom 116 (15.6%) were diabetics. Both groups, diabetic and nondiabetic, were paired according to age. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated, and a stratification analysis correlating DM and elevated BMI (>25 kg/m(2)) and WHR (>1) with the presence of subnormal FT and TT levels was performed. RESULTS: FT and TT serum levels were subnormal in 46% and 34% of diabetics, respectively, and in 24% and 23% of nondiabetics. Subnormal FT levels were strongly correlated with DM (odds ratio (OR) 2.7; 95% confidence interval (CI) 1.8-4.1) but not with elevated BMI (OR 1.4; 95% CI 1.0-2.0). Subnormal TT levels were more strongly associated with elevated BMI and WHR (OR 2.6; 95% CI 1.7-3.9 and 2.0; 1.4-2.9) than with DM (1.7; 1.1-2.6 and 2.0; 1.3-3.2). CONCLUSION: These data strongly suggest that DM is associated with subnormal FT levels, and that TT levels are influenced more by obesity and central adiposity.

Glycosylated haemoglobin levels and the severity of erectile function in diabetic men.

OBJECTIVE: To evaluate the association between the levels of glycosylated haemoglobin (HbA1c) and the severity of erectile dysfunction (ED) in men with diabetes mellitus (DM). PATIENTS AND METHODS: This cross-sectional study included sexually active men with a diagnosis of DM attending a urological medical centre from January 2000 to December 2001. The 115 men with ED (95%) completed the International Index of Erectile Function questionnaire, and fasting serum glucose and HbA1c serum levels were measured. The relationship between the severity of ED and serum HbA1c levels was assessed. RESULTS: Of men with HbA1c levels of < 8%, half had mild, and 18% and 32% had moderate and severe ED, respectively (P = 0.038); of men with HbA1c levels of > or = 8%, 25%, 29%, and 46% had mild, moderate and severe ED, respectively (P = 0.008). In addition, men with HbA1c levels of > or = 11% had a statistically higher prevalence of severe ED (P = 0.002). There was no difference in severity of ED in the HbA1c subgroups when the duration of DM was < or = 5 years (P = 0.87), but most men with HbA1c levels of > or = 8% and a history of DM of 6-10 or > 10 years had severe ED (P < 0.03). CONCLUSION: This study suggests that the severity of ED is associated with increasing HbA1c levels in diabetic men.