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Management is more complex issue than was described
| The first 150 words of the full text of this article appear below. |
EDITOR
Emberton and Anson's review of acute urinary retention was
timely and informative.1 In part of it they focused on the
use of finasteride to reduce the risk of the disease.2 We
disagree with them that the continuous administration of finasteride for four years is probably warranted in men with large prostates, moderate to severe symptoms, and poor urinary flow rates.
Firstly, the cost implications are enormous. To prevent one event
(acute urinary retention or prostatectomy) 15 patients would have to be
treated for four years at a cost of £19 475.3 Secondly, the reduction in mean symptom scores with long term finasteride treatment is small (mean reduction 3.3 points) and not comparable with
the results obtained after prostatectomy (mean reduction 19.4 points).4 Furthermore, what should happen after four years of treatment has not been established. Should finasteride treatment be
stopped, with the probability of prostatic regrowth, or should patients
take it for