Clinical Experiment Comparing 3 Pharmacological Treatments of Benign Prostatic Hypertrophy: Terazosin Vs. Finasteride Vs. Terazosin + Finasteride

Abstract

The tone of the smooth prostate muscle and the presence of hyperplastic tissue represent the dynamic and passive components respectively of the obstructive symptomatology present in benign prostatic hyperplasia (BPH). The contractile properties are mediated primarily by the alpha-1 type adrenergic receptors, which are found in great numbers in the stroma of the gland and in the prostatic capsule. The use of Terazosin, a selective alpha-1 blocker, has proved to be effective in the improvement of BPH symptoms associated with the hypertone of the smooth muscle. The assumption that androgens play an important role in hypertrophy of the prostate has introduced drugs into the treatment which are capable of blocking the synthesis and the action of testosterone and, in particular, dihydrotestosterone (DHT). Finasteride is an inhibitor of 5-alpha-reductase, the enzyme inside the prostatic epithelial cells which converts the testosterone into DHT. A multicentre study has therefore been carried out aimed at assessing, after 9 months treatment, the efficacy and tolerability of three pharmacological treatments: Terazosin, Finasteride and a combination of the two, in 146 patients with symptomatic BPH. Results of the study indicate that the drugs were well tolerated and that the efficacy in resolving the obstructive symptomatology was particularly accentuated and rapid in the groups treated with Terazosin, the action of which, in this respect, has proved to be more significant than that of Finasteride.