前立腺肥大症の抗androgen療法 : 超音波計測を中心としたallylestrenolの有効性の評価

Abstract

前立腺肥大症患者100名にAE 50 mg/日の経口治療を行った.1) 65名が16週間の投与を完了し, 副作用により投与を中止したものは3名のみであった.2)自覚的な排尿困難度, 夜間頻尿, 最大尿流量, 残尿量は有意に改善した.3)前立腺の体積および最大横断面の面積・左右径・前後径は有意に縮小したが, 全体的な形態に変化はなく仮想円面積比にも有意な変化はなかった.4)超音波計測による前立腺の体積および形態的変化と最大尿流量, 残尿量の改善には相関を認めなかった.5)副作用はほとんど認められず, 1例にごく軽度の性機能の抑制がみられたが投与中止により消失した

A multicenter trial was carried out on 100 patients with benign prostatic hypertrophy to elucidate the efficacy of anti-androgen therapy with allylestrenol (AE). AE was administered at a daily dose of 50 mg for 16 weeks to the patients and its efficacy was evaluated with subjective symptom scores, residual urine volume and uroflow rates. The effects of AE on prostatic volume and morphology were evaluated using transrectal ultrasound. Of these patients 65 completed the protocol, and only three patients withdrew from the study owing to side effects. Very modest adverse effects on sexual performance were seen in one patient. In this study, significant beneficial effects of AE on symptom scores, residual urine, maximum flow rate, and prostate size were demonstrated. However, volumetric reduction was not associated with urodynamic improvement. Prostatic shape was not changed throughout the study. These findings suggest that allylestrenol can be used as an alternative to prostatectomy in patients who are at high risk for surgery.