What are the predicting factors for the therapeutic effects of dutasteride in male patients with lower urinary tract symptoms? Investigation using a urodynamic study

摘要

Aims We investigated predicting factors for the therapeutic effects of dutasteride in patients with lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) based on a urodynamic study (UDS). Methods This was a single‐center, prospective study involving 120 male outpatients with LUTS. They received 0.5?mg of dutasteride per day for 12 months. IPSS, OABSS, IPSS‐QOL, and UDS were used for assessing subjective and objective symptoms prior to and 12 months after administration. Patient's age, PSA level, prostate volume, IPSS, OABSS, maximum flow rate, and post‐void residual urine volume, and intravesical prostatic protrusion (IPP) were set as pre‐administration parameters to predict the therapeutic effect. We evaluated the relationship between these parameters and the therapeutic effects, depending on the extent of improvement of IPSS and bladder outlet obstruction (BOO). Results A total of 104 patients with mean age of 68.9 years and mean prostate volume of 58.9?mL were included in the analysis. Thirty‐two patients (30.8%) showed an insignificant IPSS improvement of 25%, while 41 patients (39.4%) showed excellent IPSS improvement of 50% or greater. On the multivariate logistic regression analysis, IPP (95% confidence interval: 0.606‐0.810) was found to be the only factor related to the improvement in IPSS. Additionally, the multiple linear regression analysis demonstrated that IPP was the most powerful factor for predicting improvement of BOO ( r ?=??0.51, P ??0.001). Conclusions IPP is considered a useful predictor of the therapeutic effects of dutasteride for both subjective symptoms and BOO.