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Finasteride for BPH 1


Clinical bottom line

Finasteride was effective in men with prostate volumes above 40 mL.


CG Roehrborn. Meta-analysis of randomized clinical trials of finasteride. Urology 1998 51 (Suppl 4A): 46-49.


This review included six randomised trials of finasteride in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. There was no formal search, nor any information regarding trial quality or validity, though entry criteria for the six published trials is discussed and details given of prostate volume, peak flow and symptom score.


The six trials included 2,600 men. The review examines the relationship between the success of finasteride in generating changes between finasteride and placebo in terms of symptoms and flow rate to the initial prostate volume: the smaller the initial prostate volume (down to about 40 mL), the smaller the difference. The conclusion was that finasteride was effective in men with prostate volumes above 40 mL.


One of the interesting features of this study is the discussion of what constitutes a normal prostate size. It examines several autopsy and community based literature studies that determined the prostate size distribution. Most men (70-90%) had prostate volumes of 40 mL or below in these studies.