DUTASTERIDE

DUTASTERIDE

Generic Name : DUTASTERIDE

Pronunciation : doo tas' teer ide

TradeName : DUPROST soft-gelatin caps DUTAGEN cap DUTALFA Combikit DUTAS cap STERDU cap VELTRIDE tab

Why it is prescribed (Indications) : This medication is prescribed for an enlargedprostatetreatment. It blocks the production of a natural substance that enlarges theprostateand reduces the need forsurgery.

When it is not to be taken (Contraindications) : Severe liver impairment; pregnant women, children, adolescent.

Read more:DUTASTERIDEhttp://www.medindia.net/doctors/drug_information/dutasteride.htm#ixzz12LUmPCjA

Enlarged prostate: Dutasteride-tamsulosin combination therapy more effective

Enlarged prostate: Dutasteride-tamsulosin combination therapy more effective

Like any successful team effort, the best qualities of two drugs commonly prescribed for enlarged prostate yielded better results than either of the medicines alone, according to a new study from UT Southwestern Medical Center.
The findings, published in a recent issue of the journal European Urology, compared treatments for three groups of study participants with enlarged prostates over four years. The study, which included more than 4,800 men, is one of the first to compare single and combo medication regimens in such a large group.
The first group of study participants received the drug dutasteride; the second group received tamsulosin; and the third received a combination of the two medicines.
"We found the combination therapy to be superior at reducing risk of BPH progression," said Dr. Claus Roehrborn, chairman of urology at UT Southwestern and lead author of the study. "The two medications joined forces in terms of symptom control. On the strengths of both dutasteride and tamsulosin, participants reported fewer symptoms, and we observed a 25 percent reduction in prostate volume."
Dr. Roehrborn added that subjects who received the combination therapy also showed a 50 percent reduction of prostate-specific antigen (PSA), a protein produced by both cancerous and noncancerous prostate tissue. PSA levels can be an indication of increased risk ofcancer because cancer cells usually make more PSA than do benign cells, causing PSA levels in the blood to rise. Should PSA levels continue to rise after beginning therapy, patients should be monitored closely because the combination medicines do lower PSA readings, Dr. Roehrborn said.
Enlarged prostate, also called benign prostatic hyperplasia (BPH), is a common urologic condition that affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80.
Symptoms of the condition can be prolonged and severe. Prostate enlargement creates pressure on the urethra, making it difficult to urinate, which can lead to acute urinary retention. This retention causes a host of other problems, including extreme discomfort and infections.
Researchers also looked at the data to determine if the number of study participants needing surgery for BPH decreased with the combination medication regimen. Compared with tamsulosin alone, the combination of drugs reduced the incidence of acute urinary retention by 67 percent and reduced the need for BPH-related surgery by 70 percent.
"We found a 65 percent decrease in the relative risk of acute urinary retention or BPH-related surgery compared with tamsulosin alone and just over a 19 percent reduction compared with dutasteride alone," said Dr. Roehrborn.
Those taking the combination of drugs also were less likely than those in the other two groups to discontinue therapy, he said. Participants themselves noted that the combo medicines were most effective at reducing symptoms.
"There is currently no combination drug for doctors to prescribe for these patients," Dr. Roehrborn said. "This research should provide physicians better information when they decide on a course of treatment for patients with BPH."
Source: UT Southwestern Medical Center

The Effects of Dutasteride, Tamsulosin and Combination Therapy on Lower Urinary Tract Symptoms in Men With Benign Prostatic Hyperplasia and Prostatic Enlargement: 2-Year Results From the CombAT Study

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The Effects of Dutasteride, Tamsulosin and Combination Therapy on Lower Urinary Tract Symptoms in Men With Benign Prostatic Hyperplasia and Prostatic Enlargement: 2-Year Results From the CombAT Study

Claus G. Roehrborna†, Paul Siamib‡, Jack Barkinc†, Ronaldo Damiãod†, Kim Major-Walkere†, Betsy Morrille†,Francesco Montorsif§, CombAT Study Group

Received 30 June 2007 published online 13 December 2007.

Refers to article:

Mechanisms by Which a Phytotherapeutic Drug Influences Bladder Activity in Rats , 14 December 2007 Kimio Sugaya, Saori Nishijima, Shinsuke Tasaki, Katsumi Kadekawa, Minoru Miyazato, Yoshihide Ogawa The Journal of Urology February 2008 (Vol. 179, Issue 2, Pages 770-774) Abstract | Full Text | Full-Text PDF (156 KB)

Purpose

We investigated whether combination therapy with dutasteride and tamsulosin is more effective than either monotherapy alone for improving symptoms and long-term outcomes in men with moderate to severe lower urinary tract symptoms and prostatic enlargement (30 cc or greater). We report preplanned 2-year analyses.

Materials and Methods

The CombAT study is an ongoing, multicenter, randomized, double-blind, parallel group study. Men 50 years or older with a clinical diagnosis of benign prostatic hyperplasia, International Prostate Symptom Score 12 points or greater, prostate volume 30 cc or greater, total serum prostate specific antigen 1.5 ng/ml or greater to 10 ng/ml or less and peak urinary flow greater than 5 to 15 ml per second or less with a minimum voided volume of 125 ml or greater were randomized to 0.5 mg dutasteride, 0.4 mg tamsulosin or the combination once daily for 4 years. Symptoms were assessed every 3 months and peak urinary flow was assessed every 6 months. The primary end point at 2 years was the change in International Prostate Symptom Score from baseline.

Results

Combination therapy resulted in significantly greater improvements in symptoms vs dutasteride from month 3 and tamsulosin from month 9, and in benign prostatic hyperplasia related health status from months 3 and 12, respectively. There was a significantly greater improvement from baseline in peak urinary flow for combination therapy vs dutasteride and tamsulosin monotherapies from month 6. There was a significant increase in drug related adverse events with combination therapy vs monotherapies, although most did not result in the cessation of therapy.

Conclusions

In men with moderate to severe lower urinary tract symptoms and prostate enlargement (30 cc or greater) combination therapy provides a significantly greater degree of benefit than tamsulosin or dutasteride monotherapy.

Prostate Cancer Symptoms, Causes, Treatment - What are prostate cancer symptoms and signs on MedicineNet

Prostate Cancer Symptoms, Causes, Treatment - What are prostate cancer symptoms and signs on MedicineNet

What are prostate cancer symptoms and signs?

In the early stages, prostate cancer often causes no symptoms for many years. As a matter of fact, these cancers frequently are first detected by an abnormality on a blood test (the PSA, discussed below) or as a hard nodule (lump) in the prostate gland. Occasionally, the doctor may first feel a hard nodule during a routine digital (done with the finger) rectal examination. The prostate gland is located immediately in front of the rectum.

Rarely, in more advanced cases, the cancer may enlarge and press on the urethra. As a result, the flow of urine diminishes and urination becomes more difficult. Patients may also experience burning with urination or blood in the urine. As the tumor continues to grow, it can completely block the flow of urine, resulting in a painfully obstructed and enlarged urinary bladder. These symptoms by themselves, however, do not confirm the presence of prostate cancer. Most of these symptoms can occur in men with non-cancerous (benign) enlargement of the prostate (the most common form of prostate enlargement). However, the occurrence of these symptoms should prompt an evaluation by the doctor to rule out cancer and provide appropriate treatment.

Furthermore, in the later stages, prostate cancer can spread locally into the surrounding tissue or the nearby lymph nodes, called the pelvic nodes. The cancer then can spread even farther (metastasize) to other areas of the body. Symptoms of metastatic disease include fatigue, malaise, and weight loss. The doctor during a rectal examination can sometimes detect local spread into the surrounding tissues. That is, the physician can feel a hard, fixed (not moveable) tumor extending from and beyond the gland. Prostate cancer usually metastasizes first to the lower spine or the pelvic bones (the bones connecting the lower spine to the hips), thereby causing back or pelvic pain. The cancer can then spread to the liver and lungs. Metastases (areas to which the cancer has spread) to the liver can cause pain in the abdomen and jaundice(yellow color of the skin) in rare instances. Metastases to the lungs can cause chest pain and coughing.

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A Brief Introduction To Prostate Nodules

A Brief Introduction To Prostate Nodules

A prostate nodule is any growth on the prostate which can be felt upon a digital rectal examination. Characterized as hard, soft, smooth or gritty, prostate nodules or the thickening in some portions of the prostate often develop as men grow older.
The evaluation for a prostate nodule may be included in the evaluation for prostitis or a possible infection. As a rule, all prostate nodules found require further evaluation to rule out the possibility of cancer, which may come without any other symptom.
Benign Prostate Nodules
A nodule does not automatically mean that cancer is present. Hard, rocky nodules may indicate calcification or a case of benign prostatic hyperplasia, where the epithelial and prostaticstromal cells multiply and grow large enough to form large nodules around the periurethral region of the prostate. Surgical removal is often necessary if the nodule has grown large enough to block the urethral canal and cause problems with urination. Sometimes, after a PSA test has shown borderline or elevated levels and there is presence of an infection, the doctor may initially put the patient in antibiotics for 2 to 4 weeks, after which the tests are repeated. If all tests are normal within this time, cancer can be ruled out, although a repeat exam is needed in 3 to 6 months.
Cancerous Prostate Nodules
About 50% of prostate nodules are malignant. Although a digital rectal examination cannot determine whether a nodule is cancerous or not, a biopsy can. A biopsy often follows when the doctor finds abnormal results from aProstate Specific Antigen test. Once the biopsy has revealed cancer, important variables which are then taken into consideration will include grading and staging. Grading of the cancerous prostate nodule makes use of theGleason score, which determines the degree of abnormality of the prostate cells from 2 (least aggressive) to 10 (most aggressive).
Staging, on the other hand is done on the basis of the DRE. A cancerous nodule is staged as follows:
T1c (PSA detected)
T2a (small prostate nodule)
T2b (larger prostate nodule)
T3 (very large prostate nodule with probable spread outside of the prostate)
T4 (prostate cancer spreading into adjacent organ such as the bladder)
Prevention And Treatment Of Prostate Nodules
There is no known cause why the prostate tends to enlarge as men get older, and why some men found to have prostate nodules develop prostate cancer and some don’t. Experts think genes and diet may play a role. Good nutrition may contribute to overall prostate health. Men who eat fruits and vegetables, foods that naturally contain antioxidants like lycopene and minerals like selenium lowered their risk for the disease significantly.
For men in their forties or older, an annual DRE may be necessary, especially for high-risk individuals. In some cases, whether the nodule is benign or malignant, surgical excision or complete removal of the nodule may become necessary.

Acute urinary retention secondary to carcinoma of the prostate. Is initial channel TURP beneficial?

Acute urinary retention secondary to carcinoma of the prostate. Is initial channel TURP beneficial?

What is Uroflowmetry?

What is Uroflowmetry?

Normal Values

Normal values vary depending on age and sex:

• Age: 4 to 7
  • The average flow rate for both males and females is 10 mL/sec.
• Age: 8 to 13
  • The average flow rate for males is 12 mL/sec.
  • The average flow rate for females is 15 mL/sec.
• Age: 14 to 45
  • The average flow rate for males is 21 mL/sec.
  • The average flow rate for females is 18 mL/sec.
• Age: 46 to 65
  • The average flow rate for males is 12 mL/sec.
  • The average flow rate for females is 15 mL/sec.
• Age: 66 to 80
  • The average flow rate for males is 9 mL/sec.
  • The average flow rate for females is 10 mL/sec.

What abnormal results mean

Results must be understood as they relate to the patient’s complaints and physical exam. A result that may need treatment in one patient may require no treatment in another patient.

Several circular muscles normally regulate urine flow, and if any of these muscles becomes weak or stop working, an increase in urine flow or urinary incontinence may result.

If there is a bladder outlet obstruction or if the bladder muscle is weak, a decrease in urine flow may result.

Any abnormal results should be discussed with you and explained by your health care provider.