A Propensity Score-Matched Protocol: Terazosin Plus Finasteride For Benign Prostatic Hyperplasia – Sex Hormone And Urinary Control Effects

摘要

The goal of this protocol is to evaluate, using a retrospective propensity score-matched cohort design, whether terazosin combined with finasteride improves long-term urinary control and sex hormone profiles compared with finasteride monotherapy in patients with benign prostatic hyperplasia.

摘要

To investigate the clinical effect of terazosin hydrochloride combined with finasteride in benign prostatic hyperplasia (BPH), and to analyze its effect on sex hormones and urinary control. This retrospective propensity score‑matched (PSM) cohort study included BPH patients treated between January 2020 and March 2021. 1:1 PSM using logistic regression with prespecified covariates (age, BMI, IPSS, Qmax, PVR, PV, PSA, CRP, T, E2, DHT, incontinence episodes, ICIQ‑SF); inclusion criteria (age 50‑80 years, IPSS ≥ 8, PSA > 1.4 ng/mL, PV ≥ 40 mL, Qmax ≤ 15 mL/s); exclusion of prior prostate surgery or 5α‑reductase/α1‑blocker use; 12‑month treatment and 36 month follow up with outcomes measured at 6, 12, 24, 36 months. Sixty patients were allocated to each group after PSM. The combination group showed significantly greater improvements in IPSS, Qmax, PVR, and PV (all P < 0.05), lower DHT and E2, higher T (all P < 0.05), fewer 24 h incontinence episodes, and better ICIQ‑SF scores (both P < 0.05). Safety profiles were comparable (P > 0.05). The terazosin‑- finasteride regimen is associated with improved long-term outcomes, better urinary control, and favorable hormonal changes, though hormonal effects are primarily attributable to finasteride.

引言

Benign prostatic hyperplasia (BPH) is one of the most common urological diseases affecting middle-aged and elderly men. Its incidence increases with age. For example, the prevalence of BPH is about 50% in men aged 60 years and as high as 90% in those aged 81-90 years^1,2. As we age, the prostate increases in size and presses on the urethra, resulting in bladder outlet obstruction (BOO), thereby inducing lower urinary tract symptoms (LUTS), including urinary frequency, urgency, increased nocturia, dysuria, urinary retention, etc^3,4. Such symptoms markedl....

方案

This clinical study was conducted in compliance with the ethical principles outlined in the Declaration of Helsinki and was approved by the Ethics Committee of the Haiyan County People's Hospital(Approval No.: 2025-17).

Study participant assessment and selection

Clinical data were extracted for all patients diagnosed with BPH from the hospital's electronic medical record system, covering the period from January 2020 to March 2021.

PSM was employed using the 1:1 nearest-neighbor method to mitigate potential confounding factors and selection bias inherent in....

结果

The study initially enrolled 148 patients (76 in the combination group; 72 in the monotherapy group). To minimize potential confounding, 1:1 propensity score matching was applied, resulting in 120 successfully matched patients (60 per group). As presented in Table 1, significant baseline discrepancies (P < 0.05) existed before matching, with the monotherapy group being older and having higher C-reactive protein levels, total IPSS, voiding subscores, post-void residual urine, and nocturia episodes, suggesting .......

讨论

The prostate is a gonadal organ located at the bladder neck, traversed centrally by the urethra. After age 45, age‑related changes in sex hormone metabolism are associated with prostatic growth, which may progress to BPH. The condition typically evolves slowly; patients may remain asymptomatic as long as there is no lower urinary tract obstruction. As prostate volume increases, or when complicated by stones or infection, urinary obstruction and voiding difficulties may develop, potentially compromising patient heal.......

材料

本文使用的材料清单

姓名	公司	目录编号	评论
自动化学发光免疫测定分析仪	F. 霍夫曼-拉罗什有限公司	7682913001（e 801模块）	用于定量检测血清睾酮（T）、雌二醇（E2）和二氢睾酮（DHT）。
二氢睾酮（DHT）检测试剂套装	北京太阳生物科学与科技有限公司	SEKSM-0030	用于血清和血浆中DHT浓度的定量检测。
医院电子病历系统	胜利健康科技集团有限公司	HIS V5.0	用于回顾性提取患者数据。
国际失禁咨询问卷简表	—	ICI-Q-SF	用于评估尿失禁对生活质量的影响。
国际前列腺症状评分问卷	—	IPSS（LOINC 80976-4）	用于评估下尿路症状（LUTS）。
实验室离心机	赛莫飞世尔科学公司	75007201（230V）	用于血清分离。标准条件：1500小时及以下时间;G，持续10分钟。
样本量计算软件	G*力量	版本 3.1	用于先验功率分析。
性激素检测试剂套装	F. 霍夫曼-拉罗什有限公司	睾酮II：05200067	用于罗氏分析仪中血清/血浆中睾酮或雌二醇的定量检测。
统计分析软件	IBM SPSS 统计	版本25.0	用于所有数据分析。
经直肠超声诊断系统	飞利浦皇家航空公司	EPIQ 7 型号 795200	用于测量前列腺体积（PV）和排尿后残余（PVR）。
尿流量计	广州浦东医疗设备有限公司	PT-UFM-A	用于测量最大尿流量（Qmax）。