Changes in Prostate Volume, Transitional Zone Volume and PSA after Cessation of the Finasteride

Hong, Joo Eui; Hong, Sung Joon

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.