Effectiveness of Finasterid-Doxazosin Combination to treat patients with Semptomatic BPH on whom the lnvasive lntervention can not be applied

INTRODUCTION: Research for the clinical effectiveness of Finasterid- Doxazosin combination on patients with syptomatic BPH who are unsuitable to performance statue surgical treatment due to internal disease or included in ASA 4 risk group with regard to anestzy.
MATERÝAL METHOD: Total of 63 patients with semptomatic BPH who have IPSS over 7, below MFR: 10 mi! sec. and or below AFR: 8 mi! sec. participated in this research. They have been cured with Doxazosin 4 mg lxl, finasterid 5 mg lxl. Thirty of them have come f or thecontrols regularly in our following protocol. The medication had been started and 3days later urethral catheter has been removed. it had planned to follow with cystostomi tube if post miksiyonel rezidü (PMR) became over 150 mi. Controls has been done at the end of 3rd month, 6th month and 12th month. Clinical inspection, IPSS, uroflowmetri, PSA, ultrasonography has been performed in controls.
RESULTS: This research has been conducted on the total of 63 patients whose average age 73 and average prostate volume 51.8 11 patients had urethal catheter, just 1 patient couldn‘t urinate so this patient was followed via cystostomy. PMR were below 150 mi. in the rest 10 patients on the 3rd day. On the thirty patients, 30.3 % increase in MFR, 29.5 % reduction in AFR, 48.7 % reduction in IPSS obstructive symptoms, 40.5 % decrease in irritative symptoms and 39.1 % reduction in PMR, in 3rd month. in 6th month, 69 %reduction in PSA and MFR 23.0 %, AFR 20.57 % increased, Obstructive IPSS symptoms 41.02 % irritative 27.38 %decrease in prostate volume has been determined. After 1 year control, PSA 59 % decreased, MFR 6.7 % increased, AFR 20.57 % increased, obstructive IPSS symptoms 63.72
%, irritative 44.48 % and prostate volume 29.83 % decrease has been determined.
CONCLUSION: These results seems to similar with our prospective study which planned to investigate the effect of doxazocin treatment. it needs that finasterid should be discussed in that combination. But, we believe that the final conclusion on that issue may be provided with follow-up of comprehensive patient group.

Ýnvaziv Giriþim Uygulanamayacak Semptomatik BPH‘lý Hastalarýn Tedavisinde Finasterid-Doxazosin Kombinasyonunun Etkinliði

AMAÇ: Dahili hastalýðý nedeniyle peýformans statüsü cerrahi tedaviye uygun olmayan ya da anestezi açýsýndan ASA 4 risk grubuna giren semptomatikBPH‘lý hastalardafinasterid-doxazosin kombinasyonunun klinik etkinliðini araþtýrmak.
HASTALAR ve METOD: IPSS‘i 7‘nin üzerinde olan, MFR‘si 10 mllsn‘nin ve/veya AFR‘si 8ml/sn‘nin altýnda olan BPH‘lý toplam 63 hasta çalýþmaya alýndý. Doxazosin 4 mg lxl,finasterid ise 5 mg 1 xl olarak tatbik edildi. Takipte 30 hasta kontrollere düzenli olarak geldi. Sondalý hastalarda tedaviye baþlanýp, 3 gün sonra sonda alýndýðýnda postmiksiyonel rezidü _(PMR) 150 mi‘ nin üzerinde ise sistostomi tüpü ile takip edilmesi planlandý. Kontroller 3. ay, 6. ay ve 1. yýl sonunda yapýldý.. Kontrollerde ki.inik muayene, IPSS, urofowmetri, PSA ve ultrasonografik tetkikler yapýldý.
BULGULAR: Çalýþmaya yaþ ortalamasý 73 olan ve ortalama prostat volümü 51.8 olan toplam 63 hasta alýndý. Bunlardan 11 ‘i sondalý idi. Sondasý alýnan sadece 1 hasta iþeyemeyerek globa girdi ve sistostomize edildi. Geri kalan 10 olgunun 3. gün kontrollerinde PMR 150 mi altýnda idi. 30 olgunun 3. aydaki MFR‘deki %30.3, AFR‘de ise %295‘ luk bir artýþ, IPSS obstrüktif semptomlarda %48.7, irritatif semptomlarda ise %40.5 azalma, PMR‘de ise %39.1 azalma tespit edildi. 6.aydaPSA‘da %69azalma, MFR‘de %23,AFR‘de %20.57 artýþ, IPSS obstrüktif semptomlarda %41.02, irritatif semptomlarda %27 38 azalma, prostat volümünde %32.69 azalma tespit edildi. I.yýl kontrolünde PSA ‘da %59 azalma, MFR‘de %6.7, AFR‘de %20.57 artýþ, IPSS obstrüktif semptomlarda %63.72, irritatif semptomlarda%44.48 azalma, prostat volümünde %29.83 azalma tespit edildi.
SONUÇ: Bu veriler kliniðimizce sadece Doxazosin tedavisinin etkinliðini araþtýrmak üzere planlanan prospektif çalýþmamýzla uyumlu gözükmektedir.buradan dafinasterid‘in bu kombinasyonda etkinliðini sorgulamamýz gerektiði ortaya çýkar. Ancak bu konuda kesin hüküm geniþ hasta serilerinin izlenmesi sonrasýnda; elde edilebileceði kanaatindeyiz.