title: Dutasteride add-on therapy reduces detrusor mass in patients with benign prostatic enlargement not satisfied with alpha-adrenergic antagonist monotherapy: A single center prospective study.
abstract: OBJECTIVE
  The ultrasound assessment of bladder wall thickness (BWT) and intravesical prostatic protrusion (IPP) have emerged as a non-invasive, inexpensive, time-saving alternatives to pressure-flow studies to assess benign prostatic obstruction (BPO). Aim of our study was to evaluate the effect on detrusor mass of dutasteride add-on therapy in men with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE).
  
  
  METHODS
  A consecutive series of BPE patients with a prostate volume (PV) ≥30 mL and an international prostate symptoms score (IPSS) ≥8 not satisfied with Tamsulosin monotherapy were enrolled. Free maximum flow (Qmax), PV, BWT, and IPP were recorded at baseline and at 24 weeks follow-up.
  
  
  RESULTS
  Overall, 27 men were enrolled. Dutasteride significantly improved LUTS (-46.7%; P = 0.001) and Qmax (+18.7%; P = 0.001) and reduced PV (-13%; P = 0.002), BWT (-40.3%; P = 0.001), and IPP (-14.9%; P = 0.015). At baseline, based on BWT ≥5 mm and an IPP >10 mm, 13/27 (48%) and 15/27 (55%) patients were defined at risk for BPO, respectively; while after 24 weeks of treatment they were 3/27 (11.1%) and 11/27 (40%), respectively.
  
  
  CONCLUSIONS
  Dutasteride add-on therapy significantly reduced IPP and detrusor mass and was effective in improving LUTS in patients with BPE not satisfied with αBs monotherapy. The possible role of BWT and IPP as proxies of medical treatment outcomes should be confirmed by further studies.
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, "La Sapienza" University, Rome, Italy.
authors.forename: Cosimo
authors.identifier: http://orcid.org/0000-0002-2190-512X
authors.initials: C
authors.lastname: De Nunzio
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, "La Sapienza" University, Rome, Italy.
authors.forename: Aldo
authors.identifier: http://orcid.org/0000-0001-9643-8979
authors.initials: A
authors.lastname: Brassetti
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, "La Sapienza" University, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Proietti
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Serni
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, "La Sapienza" University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Esperto
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, "La Sapienza" University, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D004359:Drug Therapy, Combination; D000068538:Dutasteride / Q000627:therapeutic use*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000000981:diagnostic imaging / Q000473:pathology; D009929:Organ Size; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D001748:Urinary Bladder Neck Obstruction / Q000188:drug therapy; D014563:Urodynamics
chemical_list: D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin; D000068538:Dutasteride
keywords: BPH; LUTS; detrusor thickness; dutasteride; medical treatment; prostatic protrusion