1. ¹St. Theresienkrankenhaus, Nürnberg, Germany
2. ²Urologische Abteilung, Chirurgische Klinik, München-Bogenhausen, Germany

Correspondence: Priv Doz Dr med J Dörsam, St. Theresienkrankenhaus, Mommsenstr. 22, 90491 Nürnberg, Germany. E-mail: joachim-doersam@t-online.de

Received 16 June 2008; Revised 15 September 2008; Accepted 8 October 2008; Published online 25 November 2008.

Abstract

This literature review discusses the theoretical background of 5-reductase inhibitor (5ARI) treatment and the resulting clinical implications. A Medline-based search for peer-reviewed articles addressing 5ARIs, benign prostatic hyperplasia and prostate cancer was performed. The 5ARIs Finasteride and Dutasteride, which specifically inhibit the production of dihydrotestosterone by acting as competitive inhibitors of 5-reductase, are clinically well tolerated and represent an effective treatment option for benign prostatic obstruction. Finasteride is the first compound which has a proven efficacy in chemoprevention of prostate cancer. The aim of this review was to elucidate, if there are sufficient data available to point out clinically relevant differences between the drugs. Both compounds achieve a significant reduction of prostate volume, an improvement of symptoms and a lower risk of acute urinary retention. Whether the different pharmacokinetic and pharmacodynamic properties of Finasteride and Dutasteride are of clinical importance cannot be judged at this time.