gestonorone-caproate and Prostatic-Hyperplasia

In the development of the obstructive symptomatology of benign prostatic hypertrophy (BPH), two components may be identified, mechanical and dynamic. In the mechanical component, the interaction of a stromal and a epithelial compartment determines prostatic mass growth. The dynamic component involves smooth muscle tone in the prostate and urethra. The consideration that prostatic disease is not only epithelial in origin, but also stromal, leads to the association of an antiandrogen (which acts on the epithelial component) and an antiestrogen (active on the stromal component) in the medical therapy of BPH. In 1985 we carried out a randomized study on 256 BPH patients treated with Cyproterone acetate (CPA) plus Tamoxifen (TAM). Recently, we performed a multicenter double blind study on BPH patients treated with the association CPA plus Serenoa Repens. A statistically significant difference in prostate volume reduction between the groups treated with the combinations and those with the monotherapies was observed. The development of new compounds, such as 5 alpha reductase and aromatase inhibitors, consents to introduce a combination therapy with less side effects. A second pharmacological association may be obtained with drugs acting on the mechanical and others acting on the dynamic (alpha blockers) component of BPH. This combination may associate the early symptomatic effect of alpha blockers with the long term results of a 5 alpha reductase inhibitor, antiestrogen or aromatase inhibitor.

Topics: Bromocriptine; Cyproterone Acetate; Drug Therapy, Combination; Gestonorone Caproate; Humans; Male; Plant Extracts; Prostatic Hyperplasia; Tamoxifen

Topics: Adrenergic alpha-Antagonists; Bromocriptine; Cyproterone; Gestonorone Caproate; Humans; Male; Medrogestone; Megestrol; Plant Extracts; Polyenes; Prostatic Hyperplasia; Spironolactone; Tamoxifen

In the development of the obstructive symptomatology of benign prostatic hypertrophy (BPH), two components may be identified, mechanical and dynamic. In the mechanical component, the interaction of a stromal and a epithelial compartment determines prostatic mass growth. The dynamic component involves smooth muscle tone in the prostate and urethra. The consideration that prostatic disease is not only epithelial in origin, but also stromal, leads to the association of an antiandrogen (which acts on the epithelial component) and an antiestrogen (active on the stromal component) in the medical therapy of BPH. In 1985 we carried out a randomized study on 256 BPH patients treated with Cyproterone acetate (CPA) plus Tamoxifen (TAM). Recently, we performed a multicenter double blind study on BPH patients treated with the association CPA plus Serenoa Repens. A statistically significant difference in prostate volume reduction between the groups treated with the combinations and those with the monotherapies was observed. The development of new compounds, such as 5 alpha reductase and aromatase inhibitors, consents to introduce a combination therapy with less side effects. A second pharmacological association may be obtained with drugs acting on the mechanical and others acting on the dynamic (alpha blockers) component of BPH. This combination may associate the early symptomatic effect of alpha blockers with the long term results of a 5 alpha reductase inhibitor, antiestrogen or aromatase inhibitor.

Topics: Bromocriptine; Cyproterone Acetate; Drug Therapy, Combination; Gestonorone Caproate; Humans; Male; Plant Extracts; Prostatic Hyperplasia; Tamoxifen

Clinical trials with gestonorone led to favourable results in 65% of the patients. The drug is recommended particularly to patients in stage I or II of prostatic adenoma. It is justified to prescribe this treatment to high risk patients who cannot be operated because of their serious conditions. An objective assessment of the effect of the drug was possible by means of urodynamic and ultrasound tests which detected also fewer latent changes suggesting a continuation or repetition of the treatment.

Topics: Aged; Clinical Trials as Topic; Gestonorone Caproate; Humans; Male; Middle Aged; Prostatic Hyperplasia; Ultrasonics; Urination Disorders; Urodynamics

A placebo-controlled study with progesterone compound, 17-alpha-hydroxyprogesterone 17-n-caproate (Primostat), in 39 patients with benign enlargement of the prostate is reported. Statistical analysis of the results showed no evidence of significant improvement in patients receiving hydroxyprogesterone-caproate. No evidence of an effect as compared with the placebo was found when the residual urine, prostatic size, and histologic and ultrastructural changes of the removed prostatic gland in 6 of the patients, and in the luteinizing hormone, follicle-stimulating hormone, and estrogen urine levels in 21 patients were examined. Subjective effects, when carefully analyzed, provided some beneficial evidence, however not substantiated, when the patients' mode of voiding was carefully watched. The reported beneficial subjective improvement might be attributed to the enhancement of the beta-adrenergic response by the progesterone compound of the adrenergic receptors in the posterior urethra and bladder, presumably causing relaxation of its smooth muscle. The problems associated with the choice and measurement of parameters to be used in this type of investigation are discussed, and the absolute necessity of proper controls, statistical analysis, and close follow-up of the patients is pointed out.

Topics: Aged; Erectile Dysfunction; Estrogens; Follicle Stimulating Hormone; Gestonorone Caproate; Humans; Luteinizing Hormone; Male; Placebos; Prostate; Prostatic Hyperplasia

18 patients with obstructive benign prostatic hypertrophy were studied. A 5-day treatment with gestonorone caproate (200 mg daily and 200 mg on alternate days) and cyproterone acetate (300 mg daily) suppressed the plasma LH and serum LH levels. Subsequently, H3-testosterone was injected intravenously and its elimination from plasma and uptake and metabolism in the BPH tissue studied. The elimination of total radioactivity and H3-testosterone from plasma was not altered after the 3 treatment regimens as compared to the control group. The uptake of total radioactivity into BPH tissue and its intraprostatic metabolism particularly to dihydrotestosterone was significantly suppressed in the patients with daily injections of gestonorone. Cyproterone acetate and gestonorone caproate on alternate days did not cause this effect.

Topics: Aged; Clinical Trials as Topic; Cyproterone; Gestonorone Caproate; Humans; Luteinizing Hormone; Male; Middle Aged; Prostate; Prostatic Hyperplasia; Testosterone

Topics: 5-alpha Reductase Inhibitors; Aged; Catheterization; Gestonorone Caproate; Humans; Laser Therapy; Male; Prostatectomy; Prostatic Hyperplasia; Ultrasonic Therapy

Antiandrogen therapy has an important role in the treatment of patients with benign prostatic hypertrophy who lack indication for surgery. Herein, the effects on lipid metabolism of administration of antiandrogen agents for benign prostatic hypertrophy are reported. Eighty patients with benign prostatic hypertrophy were each treated with the antiandrogen agents, chlormadinone acetate, allylestrenol, gestonolone caproate and oxendolone for 12 months. The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), alpha-lipoprotein, apoprotein, and maronediardehyde (MDA) were measured every 4 weeks after initiation of antiandrogen treatment. In the chlormadinone acetate group, the TG level was significantly decreased between 3 and 6 months after treatment (p < 0.05). In the oxendolone group, the alpha-lipoprotein level was also elevated between 3 and 6 months and between 6 to 12 months after treatment (p < 0.05). The MDA level was also significantly elevated 6 and 12 months after treatment. However, the levels of the other lipids were within the normal range. In conclusion, the changes in the levels of plasma lipoprotein, apoprotein and MDA resulting from antiandrogen therapy were unlikely to be a cause of ischemic coronary disease.

Topics: Aged; Aged, 80 and over; Allylestrenol; Androgen Antagonists; Chlormadinone Acetate; Gestonorone Caproate; Humans; Lipid Metabolism; Lipids; Lipoproteins, HDL; Male; Malondialdehyde; Middle Aged; Nandrolone; Prostatic Hyperplasia

Various non-surgical therapeutic modalities such as balloon dilation of the prostatic urethra, hyperthermia of the prostate and medication with antiandrogens and/or adrenergic blockade have been attempted for the patients with benign prostatic hyperplasia (BPH) especially in an early stage or in a poor operative risk. The observation that androgen deprivation induces shrinkage of the hyperplastic prostate represents the basis for the treatment of BPH with antiandrogen. Although several antiandrogens are now in clinical use in our country, there still remain problems to be solved. We reviewed the mechanism of action and the clinical results of antiandrogens in the treatment of BPH. The improvement following antiandrogen therapy occurred among the patients with symptomatic BPH, in 50-80% subjectively and in 40-50% objectively. The therapy appeared to be more effective in an early stage of the disease. However, the limitation of the duration of the effects and unfavorable side effects should also be noticed. The progestational agents such as gestonorone caproate, chlormadinone acetate and allylestrenol suppress more or less sexual function by interference of the pituitary-gonadal axis. Besides, coincidental prostate cancer must be excluded since antiandrogen therapy might hinder the natural course of the cancer.

Topics: Administration, Oral; Allylestrenol; Androgen Antagonists; Chlormadinone Acetate; Drug Administration Schedule; Drug Evaluation; Gestonorone Caproate; Humans; Male; Prostatic Hyperplasia

96 patients with benign hyperplasia of the prostate and dysuric complaints in stage I and beginning stage II were treated conservatively and medicamentously up to 12 months. In the collective of patients subdivided into 4 groups the conservative therapy was carried out in 3 groups with different phyto-preparations and in one group with gestonorone capromate. The voiding of the bladder was examined by means of uroflowmetry in intervals of four weeks before and after therapy. A clear success of the effect appeared only in the group of patients treated with gestonorone capromate. With phyto-preparations uroflowmetrically no significant effect on the disturbed voiding of the bladder could be established. The conservative treatment of the benign hyperplasia of the prostate should be carried out under uroflowmetrical control, in order not to miss the time of a necessary operative intervention.

Topics: Aged; Alkaloids; Follow-Up Studies; Gestonorone Caproate; Humans; Kymography; Male; Middle Aged; Nortropanes; Piperidines; Plant Extracts; Prostatic Hyperplasia; Pyrrolidines; Sitosterols; Urine

Topics: Gestonorone Caproate; Humans; Isoenzymes; L-Lactate Dehydrogenase; Male; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms

A study was carried out in 30 male patients with benign prostate hyperplasia to assess the effectiveness of treatment with a progestational agent, gestonorone caproate (200 mg), given intramucularly every 7 days over a period of 2 to 3 months. The results showed definite subjective and objective improvement after treatment. Residual urine determination diminished significantly after therapy in 78% of the cases completing the study; uroflometry also showed improvement. There appeared to be some reduction in the degree of occlusion of the urethral lumen in at least 13(65%) out of 20 patients given follow-up cystopanendoscopy after 6 months. This result was further supported by improvement in urinary flow rates and uroflometrograms in the same patients. The only adverse effect of treatment noted was the development of impotency in 21 patients.

Topics: Aged; Cystoscopy; Drug Evaluation; Erectile Dysfunction; Gestonorone Caproate; Humans; Male; Middle Aged; Prostatic Hyperplasia; Urination; Urination Disorders

Topics: Androgen Antagonists; Cyproterone; Germany, West; Gestonorone Caproate; Humans; Male; Progestins; Prostatic Hyperplasia; Testosterone

Topics: Animals; Dihydrotestosterone; Gestonorone Caproate; Male; Oxidoreductases; Prostate; Prostatic Hyperplasia; Rats; Testosterone

Topics: Androstanes; Chemical Phenomena; Chemistry; Chromatography; Diethylstilbestrol; Estradiol; Gestonorone Caproate; Humans; In Vitro Techniques; Kinetics; Male; Oxidoreductases; Progesterone; Prostatic Hyperplasia; Testosterone; Tritium

Topics: Androstanes; Androstenedione; Diethylstilbestrol; Dihydrotestosterone; Gestonorone Caproate; Humans; In Vitro Techniques; Kinetics; Male; Oxidoreductases; Prostate; Prostatic Hyperplasia; Testosterone; Tritium

Topics: Abdomen; Aged; Delayed-Action Preparations; Gestonorone Caproate; Humans; Injections, Intravenous; Male; Middle Aged; Muscles; Prostate; Prostatic Hyperplasia; Receptors, Drug; Testosterone; Tritium

Topics: Gestonorone Caproate; Humans; Kymography; Male; Prostatic Hyperplasia; Urinary Bladder Neck Obstruction; Urine

Topics: Animals; Gestonorone Caproate; Haplorhini; Humans; Male; Organ Size; Prostatic Hyperplasia; Rats; Urination

Topics: Aged; Evaluation Studies as Topic; Gestonorone Caproate; Humans; Male; Methods; Middle Aged; Pregnenes; Pressure; Progestins; Prostatic Hyperplasia; Urinary Bladder; Urination