5-알파환원효소억제제(Finasteride) 투약 중단 후 보이는 전립선 크기, 전립선이행대 크기 및 PSA 변화 양상

Abstract

PURPOSE: Finasteride is an inhibitor of human 5alpha-reductase, which results in a decrease in plasma and intraprostatic dihydrotestosterone(DHT) level. We investigated the changes of prostate volume(PV), transitional zone volume(TV), and PSA during and after administration of finasteride. MATERIALS AND METHODS: From 1995, 32 BPH patients treated with finasteride underwent surveillance after cessation of finasteride. Surveillance included measurements of PV, TV and PSA every 3 to 6 months. The mean age of the patients was 66.7 years(57-73). The mean duration of treatment and cessation were 8.6 months(6-12) and 8.0 months(6-12), respectively. The changes in PV, TV, and PSA were compared. RESULTS: The mean initial PV, TV, PSA were 45.7cc, 22.5cc, 2.72ng/ml, respectively. After treatment, PV, TV, PSA were reduced to 72.7%, 67.1%, 64.7% and 68.0%, 61.4%, 57.3% and 59.4%, 55.0%, 52.5% of the original values at 3, 6 and 12 months, respectively. The reduction rate was maximum after the first 3 months(p=0.001). After discontinuing finasteride, PV, TV, PSA recovered to 71.0%, 71.2% 63.9% and 84.0%, 82.3%, 67.6% and 90.4%, 85.1%, 74.1% at 3, 6 and 12 months, respectively. The recovery rates of PV and TV after 3 and 6 months were equal. However, recovery rate of PSA was maximum at 3 months and after then, constant until 12 months. CONCLUSIONS: During first 3 months` treatment, the decreasing rates of PV, TV and PSA were very considerable, after then, reduced. After cessation of medication the recovery rates of PV, TV were constant during first 6 months but PSA was maximum at first 3 months. The changes in clinical parameters during administration were fully recovered but it took slightly longer periods after cessation compared to those during of treatment. PSA is probably a predictor in the assessment of volume changes.