Successes and Failures of Evidence-Based Urology

    January 2005
    Peter Boyle
    TLDR Evidence-based urology improved treatment and quality of life for conditions like BPH by shifting from surgery to effective medications like finasteride and dutasteride.
    The document discussed the application of an evidence-based approach in urology, highlighting both successes and challenges. It emphasized the shift from using death statistics to focusing on symptomatic disease and quality of life in conditions like benign prostatic hyperplasia (BPH), erectile dysfunction, and incontinence. The research led to the development of questionnaire-based evaluations for urological conditions and identified the prevalence of these conditions in aging populations. A significant finding was that treatment for BPH evolved from surgical to pharmacologic options, with finasteride proving effective for men with enlarged prostates by inhibiting 5-alpha reductase. The research also demonstrated that serum PSA levels could indicate prostate volume, aiding in identifying suitable candidates for finasteride, which reduced the risk of acute urinary retention (AUR) more effectively than alpha-blockers. Additionally, phase III trials of dutasteride confirmed similar benefits, and a method was developed to predict individual AUR risk in men with BPH.
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      community risks with finasteride and dutasteride

      in Research/Science  142 upvotes 5 months ago
      Finasteride and dutasteride have potential risks, including post-finasteride syndrome, but are commonly used for hair loss. RU58841, minoxidil, and needling are suggested as alternatives, though all treatments carry risks.
      FCE 28260: A Forgotten 5α-Reductase Inhibitor

      community FCE 28260: A Forgotten 5α-Reductase Inhibitor

      in Research  330 upvotes 1 year ago
      FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

      community Wtf have we been doing for the last 30 years

      in Treatment  548 upvotes 11 months ago
      Hair loss treatments like finasteride, minoxidil, and dutasteride work but have side effects. A permanent cure is still not available due to the complexity of hair loss and limited investment.

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