Dihydrotestosterone and the concept of 5alpha-reductase inhibition in human benign prostatic hyperplasia.


:The development of human benign prostatic hyperplasia (BPH) clearly requires a combination of testicular androgens and the ageing process. Although the role of androgens as the causative factor for human benign prostatic hyperplasia is debated, they undoubtedly play, at least, a permissive role. The principal prostatic androgen is dihydrotestosterone. Although not elevated in human benign prostatic hyperplasia, dihydrotestosterone levels in the prostate remain at a normal level with ageing, despite a decrease in the plasma testosterone. Dihydrotestosterone (DHT) is generated by a reduction in testosterone. Two isoenzymes of 5alpha-reductase have been discovered. Type 1 is present in most tissues in the body where 5alpha-reductase is expressed, and is the dominant form in sebaceous glands. Type 2 5alpha-reductase is the dominant isoenzyme in genital tissues, including the prostate. Finasteride is a 5alpha-reductase inhibitor that has been used to treat BPH and male-pattern baldness. At doses used clinically, its major effect is to suppress type 2 5alpha-reductase, because it has a much lower affinity for the type 1 isoenzyme. Finasteride suppresses DHT by about 70% in serum and by as much as 85%-90% in the prostate. The remaining DHT in the prostate is likely to be the result of type 1 5alpha-reductase. The suppression of both 5alpha-reductase isoenzymes with GI198745 results in greater and more consistent containment of serum dihydrotestosterone than that observed with a selective inhibitor of type 2 5alpha-reductase. Physiological and clinical studies comparing dual 5alpha-reductase inhibitors, such as GI198745, with selective type 2, such as finasteride, will be needed to determine the clinical relevance of type 1 5alpha-reductase within the prostate. There have been two large, international multicentre, phase III trials published documenting the safety and efficacy of finasteride in treating human benign prostatic hyperplasia. Combining these two studies, randomised, controlled data are available for 12 months. Non-controlled extension of these data from a subset of patients, who elected to continue on the drug for 3, 4 and 5 years, are also available. Long-term medical therapy with finasteride can reduce clinically significant endpoints, such as acute urinary retention or surgery. According to the meta-analysis of six randomised, clinical trials with finasteride, finasteride is most effective in men with large prostates. A more effective dual inhibitor of type 1 and 2 human 5alpha-reductase may lower circulating dihydrotestosterone to a greater extent than finasteride and show advantages in treating human benign prostatic hyperplasia and other disease states that depend on dihydrotestosterone. A clinical evaluation of potent dual 5alpha-reductase inhibitors may help to define the relative roles of human type 1 and 2 5alpha-reductase in the pathophysiology of benign prostatic hyperplasia and other androgen-dependent diseases.


World J Urol


World journal of urology


Bartsch G,Rittmaster RS,Klocker H





Has Abstract


2002-04-01 00:00:00












  • Expression of transient receptor potential vanilloid 4 and effects of ruthenium red on detrusor overactivity associated with bladder outlet obstruction in rats.

    abstract:PURPOSE:To investigate transient receptor potential vanilloid 4 (TRPV4) expression and the effects of ruthenium red (RR)-TRPV antagonist-on detrusor overactivity (DO) associated with bladder outlet obstruction (BOO). METHODS:Rats were randomly assigned to 3 groups. The control group (n = 10) included sham-operated rat...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Cho KJ,Park EY,Kim HS,Koh JS,Kim JC

    更新日期:2014-06-01 00:00:00

  • Adjuvant treatment of locally advanced renal cancer with autologous virus-modified tumor vaccines.

    abstract::We report on 208 patients with locally advanced renal-cell carcinoma who received a surgical adjuvant vaccination with autologous, Newcastle disease virus (NDV)-modified, and lethally irradiated tumor cells in combination with low-dose recombinant interleukin-2 and interferon-alpha. The pathological stage was defined ...

    journal_title:World journal of urology

    pub_type: 临床试验,杂志文章


    authors: Kirchner HH,Anton P,Atzpodien J

    更新日期:1995-01-01 00:00:00

  • Impact of using 29 MHz high-resolution micro-ultrasound in real-time targeting of transrectal prostate biopsies: initial experience.

    abstract:PURPOSE:This report presents our early experience at Cleveland Clinic replacing conventional ultrasound with a novel 29 MHz high-resolution micro-ultrasound system for both systematic sampling and real-time targeting of suspicious regions during prostate biopsy. The added value of micro-ultrasound and MRI over systemat...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Abouassaly R,Klein EA,El-Shefai A,Stephenson A

    更新日期:2020-05-01 00:00:00

  • Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic.

    abstract:OBJECTIVES:While the coronavirus disease 2019 (COVID-19) pandemic captures healthcare resources worldwide, data on the impact of prioritization strategies in urology during pandemic are absent. We aimed to quantitatively assess the global change in surgical and oncological clinical practice in the early COVID-19 pandem...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Dotzauer R,Böhm K,Brandt MP,Sparwasser P,Haack M,Frees SK,Kamal MM,Mager R,Jäger W,Höfner T,Tsaur I,Haferkamp A,Borgmann H

    更新日期:2020-07-04 00:00:00

  • Multivariate risk prediction tools including MRI for individualized biopsy decision in prostate cancer diagnosis: current status and future directions.

    abstract:BACKGROUND AND PURPOSE:Individualized risk-adapted algorithms in prostate cancer (PCa) diagnosis using predictive prebiopsy variables in addition to prostate-specific antigen value may result in a considerable reduction of unnecessary systematic biopsies. Multi-parametric magnetic resonance imaging (mpMRI) has emerged ...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Schoots IG,Roobol MJ

    更新日期:2020-03-01 00:00:00

  • Following the crowd: patterns of crowdsourcing on Twitter among urologists.

    abstract:PURPOSE:To examine patterns of crowdsourcing on the social media platform Twitter among urologists. METHODS:Urologists' public Twitter accounts were reviewed for original posts seeking clinical advice or feedback, and associated reply posts, before and after the 140-character-limit expansion in 2017. Predictors of res...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Koo K,Shee K,Gormley EA

    更新日期:2019-03-01 00:00:00

  • Prognostic effect of cytoreductive nephrectomy in synchronous metastatic renal cell carcinoma: a comparative study using inverse probability of treatment weighting.

    abstract:PURPOSE:To test the hypothesis that cytoreductive nephrectomy (CN) improves overall survival (OS) of patients with synchronous metastatic renal cell carcinoma (mRCC), who subsequently receive targeted therapies (TT). METHODS:We identified 261 patients who received TT for synchronous mRCC with or without prior CN. To a...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Klatte T,Fife K,Welsh SJ,Sachdeva M,Armitage JN,'Aho T,Riddick AC,Matakidou A,Eisen T,Stewart GD

    更新日期:2018-03-01 00:00:00

  • Effect of testosterone, raloxifene and estrogen replacement on the microstructure and biomechanics of metaphyseal osteoporotic bones in orchiectomized male rats.

    abstract:INTRODUCTION:Currently, osteoporosis research is rarely undertaken in males but an increase in male life expectancy in the company of hypogonadism suggests the necessity for potential therapeutic options. MATERIALS AND METHODS:In this study, the changes in bone structure under standardized testosterone- (T), raloxifen...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Stuermer EK,Sehmisch S,Tezval M,Tezval H,Rack T,Boekhoff J,Wuttke W,Herrmann TR,Seidlova-Wuttke D,Stuermer KM

    更新日期:2009-08-01 00:00:00

  • Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer: does FISH positivity anticipate recurrence?

    abstract:BACKGROUND:The significance of a positive UroVysion FISH assay is uncertain in patients with normal cystoscopy. This multicenter study evaluates the clinical significance of a positive FISH assay in patients with no visible tumor and excluding those with a positive cytology. METHODS:A multi-institutional, retrospectiv...

    journal_title:World journal of urology

    pub_type: 杂志文章,多中心研究


    authors: Seideman C,Canter D,Kim P,Cordon B,Weizer A,Oliva I,Rao J,Inman BA,Posch M,Herr H,Lotan Y

    更新日期:2015-09-01 00:00:00

  • The ileal neobladder in female patients with bladder cancer: long-term clinical, functional, and oncological outcome.

    abstract:PURPOSE:To assess long-term clinical and oncological outcome in women undergoing radical cystectomy and ileal neobladder reconstruction for invasive bladder cancer. METHODS:From 1995 to 2010, a total of 121 women with clinically organ-confined urothelial carcinoma underwent radical cystectomy with an orthotopic ileal ...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Jentzmik F,Schrader AJ,de Petriconi R,Hefty R,Mueller J,Doetterl J,Eickhoff A,Schrader M

    更新日期:2012-12-01 00:00:00

  • Prognostic impact of infiltration of the vagina and/or uterus in women undergoing anterior pelvic exenteration for urothelial carcinoma of the bladder: results of a contemporary multicentre series.

    abstract:PURPOSE:To evaluate for the first time the prognostic significance of female invasive patterns in stage pT4a urothelial carcinoma of the bladder in a large series of women undergoing anterior pelvic exenteration. PATIENTS AND METHODS:Our series comprised of 92 female patients in total of whom 87 with known invasion pa...

    journal_title:World journal of urology

    pub_type: 杂志文章,多中心研究


    authors: May M,Aziz A,Brookman-May S,Roghmann F,Noldus J,Rink M,Chun F,Fisch M,Novotny V,Wirth M,Mayr R,Pycha A,Brisuda A,Volkmer B,Stredele R,Dechet C,Vallo S,Haferkamp A,Schnabel M,Denzinger S,Roigas J,Stief CG,Gilfr

    更新日期:2015-03-01 00:00:00

  • The impact of time to catheter removal on short-, intermediate- and long-term urinary continence after radical prostatectomy.

    abstract:PURPOSE:To assess the impact of prolonged catheterization time on 1-week (short-term), 3-month (intermediate-term) and 1-year (long-term) UC. METHODS:Between 2008 and 2015, 6918 men underwent RP by four high-volume surgeons. Exclusion criteria were baseline urinary incontinence (UI) and radiotherapy prior or within 12...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Tilki D,Preisser F,Karakiewicz P,Shariat SF,Graefen M,Huland H,Chun FK,Pompe RS

    更新日期:2018-08-01 00:00:00

  • Mass spectrometry based proteomics in urine biomarker discovery.

    abstract::All organisms contain 1,000s of proteins and peptides in their body fluids, which undergo disease-specific changes. Advances in the understanding of the functional relevance of these polypeptides under different (patho)physiological conditions and the identification of indicative changes with disease would greatly enh...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Theodorescu D,Mischak H

    更新日期:2007-10-01 00:00:00

  • Understanding patients' preferences for surgical management of urethral stricture disease.

    abstract:OBJECTIVES:To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. PATIENTS AND METHODS:Male patients with urethral stricture disease participated in a choice-base...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Hampson LA,Lin TK,Wilson L,Allen IE,Gaither TW,Breyer BN

    更新日期:2017-11-01 00:00:00

  • Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma.

    abstract:INTRODUCTION:The conservative management of upper tract urothelial carcinoma (UTUC) has historically been offered to patients with imperative indications. The recent International Consultation on Urologic Diseases (ICUD) publication on UTUC stratified treatment allocations based on high- and low-risk groups. This repor...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Mandalapu RS,Remzi M,de Reijke TM,Margulis V,Palou J,Kapoor A,Yossepowitch O,Coleman J,Traxer O,Anderson JK,Catto J,de la Rosette J,O'Brien T,Zlotta A,Matin SF

    更新日期:2017-03-01 00:00:00

  • Androgen receptor co-activators in the regulation of cellular events in prostate cancer.

    abstract:OBJECTIVES:Androgen receptor (AR) action in benign and malignant tissue is potentiated by a number of co-regulatory proteins that may interact with one or more receptor domains. With improvement of research methodologies, it became possible to detect a number of co-activators whose expression is increased in prostate c...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Culig Z,Santer FR

    更新日期:2012-06-01 00:00:00

  • Long-term subjective continence status and use of alternative treatments by women with stress urinary incontinence after collagen injection therapy.

    abstract::This study examined subjective continence status and use of subsequent alternative therapeutic procedures at long-term follow-up after collagen injection for stress incontinence (SI) in women. Seventy women who underwent collagen injection for SI were identified by retrospective chart review and surveyed by mail quest...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Sakamoto K,Sharma S,Wheeler JS

    更新日期:2007-08-01 00:00:00

  • Evaluation of sexual function in women at two stages of multiple sclerosis.

    abstract:PURPOSE:In the present study, we aimed to evaluate the sexual function in patients with multiple sclerosis (MS) who were examined in two subgroups and compare the results to the control group with a validated questionnaire. METHODS:A total of 23 consecutive female MS patients divided into groups with relapsing-remitti...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Firdolas F,Ozan T,Onur R,Bulut S,Orhan I

    更新日期:2013-08-01 00:00:00

  • The vacuum cleaner effect in minimally invasive percutaneous nephrolitholapaxy.

    abstract:INTRODUCTION:Percutaneous stone removal increasingly plays an important role among the different approaches of interventional stone therapy, particularly since the development of miniaturized instruments is resulting in lower morbidity for the patients. One major drawback of smaller instruments is the increased difficu...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Nicklas AP,Schilling D,Bader MJ,Herrmann TR,Nagele U,Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group.

    更新日期:2015-11-01 00:00:00

  • Single-use flexible ureteropyeloscopy: a systematic review.

    abstract:PURPOSE:Data assessing the effectiveness of single-use flexible ureteropyeloscopy (FURS) are limited. This study evaluates and compares single-use FURS with conventional reusable FURS. METHODS:A systematic search using electronic databases (Pubmed and Embase) was performed for studies evaluating single-use FURS in the...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Davis NF,Quinlan MR,Browne C,Bhatt NR,Manecksha RP,D'Arcy FT,Lawrentschuk N,Bolton DM

    更新日期:2018-04-01 00:00:00

  • Scrutiny of cardiovascular risk factors by assessing arterial stiffness in erectile dysfunction patients.

    abstract:PURPOSE:Erectile dysfunction (ED) is an early sign of vascular dysfunction. Studies have reported a correlation between arterial stiffness and cardiovascular events. The objective of this study was to evaluate the association among different criteria for assessing arterial stiffness and cardiovascular risk factors in E...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Chang ST,Chu CM,Hsu JT,Chung CM,Pan KL,Hsiao JF,Lin YS

    更新日期:2010-10-01 00:00:00

  • Complications of primary retroperitoneal lymph-node dissection for low-stage testicular cancer.

    abstract::The surgical complications encountered in 478 patients who underwent primary retroperitoneal lymph-node dissection for clinical stage A and B nonseminomatous testicular cancer during the period ranging from 1982 to 1992 were reviewed. There were 54 complications in 51 patients (10.6%), and there was no surgery-related...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Baniel J,Foster RS,Rowland RG,Bihrle R,Donohue JP

    更新日期:1994-01-01 00:00:00

  • Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study.

    abstract:PURPOSE:To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery. PATIENTS AND METHODS:A main stone >10 mm or stones g...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Piao S,Park J,Son H,Jeong H,Cho SY

    更新日期:2016-05-01 00:00:00

  • Minimally invasive robotic versus conventional open living donor kidney transplantation.

    abstract:PURPOSE:First robotic-assisted kidney transplants (RAKT) were performed in Germany in 2016. To introduce and establish this method as a routine procedure for patients in transplantation medicine, our 2-year experiences are presented. METHODS:Non-randomized open-label cohort study to compare functional and operative re...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Pein U,Girndt M,Markau S,Fritz A,Breda A,Stöckle M,Mohammed N,Kawan F,Schumann A,Fornara P,Weigand K

    更新日期:2020-03-01 00:00:00

  • The effect of intra- and postoperative allogenic blood transfusion on patients' survival undergoing radical cystectomy for urothelial carcinoma of the bladder.

    abstract:PURPOSE:Radical cystectomy (RC) can be associated with significant blood loss. Allogenic blood transfusion (ABT) may alter disease outcome because of a theoretical immunomodulatory effect. We evaluated the effects of ABT on overall survival (OS) and progression-free survival (PFS) of patients undergoing RC for urotheli...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Gierth M,Aziz A,Fritsche HM,Burger M,Otto W,Zeman F,Pawlik MT,Hansen E,May M,Denzinger S

    更新日期:2014-12-01 00:00:00

  • Laparoscopic management of renal cystic disease.

    abstract::Renal cystic disease, ranging from simple cysts to autosomal dominant polycystic kidney disease (ADPKD), can lead to significant complications such as pain, hypertension, infection, upper urinary tract obstruction, and even renal failure. For patients with preserved renal function, laparoscopic ablation of renal cysts...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Dunn MD,Clayman RV

    更新日期:2000-09-01 00:00:00

  • Role of cathepsin D in prostatic cancer cell growth and its regulation by brefeldin A.

    abstract::We investigated a possible relationship between brefeldin A (BFA), an antibiotic, and cathepsin D (Cat.D), a lysosomal protease, in prostate cancer proliferation. Effects of BFA (30 ng/ml) were examined on the growth of three human prostatic cancer cell lines, PC-3, DU-145, and LNCaP cells. Its effect on Cat.D in thes...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Konno S,Cherry JP,Mordente JA,Chapman JR,Choudhury MS,Mallouh C,Tazaki H

    更新日期:2001-08-01 00:00:00

  • Higher expression of phosphodiesterase type 5 in the anterior fibromuscular stroma of the human prostate.

    abstract:PURPOSE:To examine phosphodiesterase type 5 (PDE5) expression in the anterior fibromuscular stroma (AFMS) of the prostate. Although PDE5 expression was identified in the human prostate, differences in PDE5 expression in intra-prostatic regions are unknown. The AFMS in the prostate has peculiar innervations that could c...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Iwata T,Fujihara A,Shiraishi T,Yamada Y,Hongo F,Ukimura O

    更新日期:2020-11-01 00:00:00

  • Durability of laser fibers.

    abstract::In 90 patients treated with laser prostatectomy using the Urolase (n = 50) or Ultraline (n = 40) laser fiber, the fiber-tip durability was investigated. In general the Urolase fiber tips were less damaged than the Ultraline fiber tips. At visual inspection, 62% of the Urolase fiber tips were graded as minimally damage...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: te Slaa E,van Ettergem AF,van 't Hof CA,Debruyne FM,de la Rosette JJ

    更新日期:1995-01-01 00:00:00

  • Surgical options for open adrenalectomy.

    abstract::We are fortunate that our ability to diagnose the specific adrenal entities that mandate a surgical approach is extremely accurate. The combination of analytical methodology to measure the appropriate adrenocortical and medullary hormone production and the radiology techniques for localization are superb. The manageme...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Vaughan ED Jr

    更新日期:1999-02-01 00:00:00