Breaking News in Urology

February 26, 1998
Adapted from the original published article:

Proscar Decreases Need For BPH Surgery

McConnell, J.D., Bruskewitz, R., Walsh, P, et al.
New England Journal of Medicine, 338: 557, 1998 (Feb. 26)

The Effect of Finasteride on the Risk of Acute Urinary Retention and the Need for Surgical Treatment Among Men with Benign Prostatic Hyperplasia.

Men with symptomatic BPH, who are taking finasteride (Proscar), appear to have their need for surgery cut in half, according to Dr. John McConnell and colleagues, writing in the lead article of the Februry 26, 1998 New England Journal of Medicine.

In this 4-year placebo-controlled study, involving more than 3000 men, the incidence of surgical intervention was 10% in the placebo group and five percent in the finasteride group. The incidence of acute urinary retention was three percent in the finsteride group, compared to seven percent in the controls. Treated patients experienced a sustained decrease in symptom score and prostate volume, with a sustained improvement in urinary flow. Regarding serious adverse side-effects, no significant differences were observed between placebo and treated men.

In an accompanying editorial, Dr. John Wasson stated, " now a proven treatment for men who wish to reduce the...symptoms or the risk of serious complications of BPH." However, Dr. Wasson continues, the drug is not for everybody because (1) BPH is not always progressive (2) quality-of-life issues have not been thoroughly assessed, (3) cost may be an issue, and (4) not all men are bothered by their symptoms. He concludes, "Patients and clinicians must balance these costs against the costs of alternative treatment approaches, including no treatment at all."

Read the abstract.

Two peer-reviewed publications from USRF are online:

1. Prostate tissue composition.
2. Free PSA.

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