Can Patients With LUTS and BPH Discern Changes in Peak Urinary Flow Rate and Do Such Changes Contribute to Overall Satisfaction With Treatment?

The document reviewed the efficacy of finasteride in treating benign prostatic hyperplasia (BPH) and its impact on patients' satisfaction with treatment. Finasteride significantly reduced serum and intraprostatic dihydrotestosterone levels by 70% to 80% and decreased total gland size by 15% to 25%, particularly in the periurethral zone. Larger baseline prostate size correlated with greater improvements in urinary flow rate and symptom scores. Health-related quality of life improved with finasteride, and long-term studies indicated a reduction in acute urinary retention and surgery rates. Combination therapy with α blockers showed no significant advantage over α blockers alone. Prostate cancer detection rates were similar between finasteride and placebo groups. The findings suggested that finasteride's role in treating BPH should be evaluated based on baseline prostate volume, prostate-specific antigen values, and potential combination with α blockers.