Treatment with Cyproterone Acetate and/or Bromocriptine

  • Peter Ekman


Drug therapy for urinary obstruction due to benign prostatic hyperplasia (BPH) has been used for centuries in different cultures, primitive as well as civilized. The introduction of modern surgery and its application in cases of urinary obstruction lessened the interest in a pharmacological approach to this problem. A new era started with the careful studies of Huggins and co-workers24,28,29 during the 1940s clarifying the endocrine dependency of the normal and diseased prostate gland. Since then many different protocols for endocrine therapy have been devised. The results have varied, and no drug regimen has been generally accepted.43 One major reason is that surgery usually efficiently relieves the patient’s symptoms and therefore remains the primary choice of therapy. Another reason is that most studies have been less well designed with poorly defined objective criteria;5 they have seldom been randomized double-blind, or placebo-controlled.


Benign Prostatic Hypertrophy Cyproterone Acetate Prostatic Size Progestin Receptor Bladder Neck Obstruction 
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  1. 1.
    Andersson KE, Ek A, Persson CGA: Effects of PG on the isolated human bladder and urethra. Acta Physiol Scand 100: 165–171, 1977PubMedCrossRefGoogle Scholar
  2. 2.
    Aragona C, Friesen HG: Specific prolactin binding sites in the prostate and testis of rats. Endocrinology 97: 677–684, 1975PubMedCrossRefGoogle Scholar
  3. 3.
    Asano M: Basic experimental studies on the pituitary prolactin-prostate inter-relationship. J Urol 93: 87–93, 1965PubMedGoogle Scholar
  4. 4.
    Bashirelahi N, Young JD Jr, Sidh S, Sanefuji H: Androgen, oestrogen and progestogen and their distribution in epithelial and stromal cells of human prostate. In Schröder FH, de Voogt HJ (eds.): Steroid Receptors, Metabolism and Prostatic Cancer. Excerpta Medica, Amsterdam, 1980, pp 240–256Google Scholar
  5. 5.
    Boyarsky S, Jones G, Paulson DF, Prout GR Jr: A new look at bladder neck obstruction by the Food and Drug Administration regulators: guidelines for investigation of benign prostatic hypertrophy. Trans Am Assoc Genitourin Surg 68: 29–32, 1977Google Scholar
  6. 6.
    Bridge RW, Scott WW: A new antiandrogen, SH- 714. Invest Urol 2: 99–103, 1964PubMedGoogle Scholar
  7. 7.
    Clark JH, Peck EJ Jr: Female Sex Steroids. Receptors and Function. Springer-Verlag, Berlin, 1979Google Scholar
  8. 8.
    Cowan RA, Cowan SK, Grant JK: Binding of methyltrienolone (R1881) to a progesterone receptor-like component of human prostatic cytosol. J Endocrinol 74: 281–289, 1977PubMedCrossRefGoogle Scholar
  9. 9.
    De Voogt HJ, Dingjan PG: Steroid receptors in human prostatic tissue, a preliminary evaluation. Urol Res 6: 151–158, 1978PubMedCrossRefGoogle Scholar
  10. 10.
    Dube JY, Chapdelaine P, Tremblay RR, Bonne C, Raynaud JP: Comparative binding specificity of methyltrienolone in human and rat prostate. Horm Res 7: 341–347, 1976PubMedCrossRefGoogle Scholar
  11. 11.
    Dube JY, Lesage R, Tremblay RR: Estradiol and progesterone receptors in dog prostate cytosol. J Steroid Biochem 10: 459–466, 1979PubMedCrossRefGoogle Scholar
  12. 12.
    Ekman P: Clinical significance of steroid receptor assay in the human prostate. In Schröder FH, de Voogt JH (eds.): Steroid Receptors, Metabolism and Prostatic Cancer. Excerpta Medica, Amsterdam, 1980, pp 209–224Google Scholar
  13. 13.
    Ekman P, Johansson B, Ohlsen H, Ringertz H: Drug therapy in benign prostatic hyperplasia. Scand J Urol Nephrol (Suppl) 60: 77–80, 1981Google Scholar
  14. 14.
    Ekman P, Snochowski M, Dahlberg E, Bression D, Hogberg B, Gustafsson JA: Steroid receptor content in cytosol from normal and hyperplastic human prostate. J Clin Endocrinol Metab 49: 205–215, 1979PubMedCrossRefGoogle Scholar
  15. 15.
    Farrar DJ, Osborne JL: The use of bromocriptine in the treatment of unstable bladder. Br J Urol 48: 235–238, 1976PubMedGoogle Scholar
  16. 16.
    Farrar DJ, Pryor JS: The effect of bromocriptine in patients with benign prostatic hypertrophy. Br J Urol 48: 73–75, 1976PubMedCrossRefGoogle Scholar
  17. 17.
    Geller J: Medical treatment of benign prostatic hypertrophy. In Castro JE (ed.): The Treatment of Prostatic Hypertrophy and Neoplasia. MTP, Lancaster, 1974, pp 27–58Google Scholar
  18. 18.
    Geller J, Albert J, Geller S, Lopez D, Cantor T, Yen S: Effect of megestrol acetate (Megace®) on steroid metabolism and steroid-protein binding in the human prostate. J Clin Endocrinol Metab 43: 1000–1008, 1976PubMedCrossRefGoogle Scholar
  19. 19.
    Geller J, Angrist A, Nakao K, Newman H: Therapy with progestational agents in advanced benign prostatic hypertrophy. JAMA 210: 1421–1427, 1969PubMedCrossRefGoogle Scholar
  20. 20.
    Geller J, Bora R, Roberts T, Newman H, Lin A, Silva R: Treatment of benign prostatic hypertrophy with hydroxyprogesterone caproate: effect on clinical symptoms, morphology, and endocrine function. JAMA 193: 121–128, 1965PubMedGoogle Scholar
  21. 21.
    Geller J, Fishman J, Cantor TL: Effect of cyproterone acetate on clinical, endocrine and pathological features of benign prostatic hypertrophy. J Steroid Biochem 6: 837–843, 1975PubMedCrossRefGoogle Scholar
  22. 22.
    Graf KJ, Koch UJ, Lorenz F, Hammerstein J, Schmidt-Gollwitzer M: Hyperprolactinemia induced by cyproterone acetate in human subjects. Dtsch Ges Endocrinol, abstract, 1978Google Scholar
  23. 23.
    Grayhack JT, Bunce PL, Kearns JW, Scott WW: Influence of the pituitary on prostatic response to androgen in the rat. Bull Johns Hopkins Hosp 96: 154–163, 1955PubMedGoogle Scholar
  24. 24.
    Grayhack JT, Lebowitz JM: Effect of prolactin on citric acid of lateral lobe of prostate of Sprague- Dawley rat. Invest Urol 5: 87–94, 1967Google Scholar
  25. 25.
    Gustafsson JA, Ekman P, Pousette A, Snochowski M, Högberg B: Demonstration of a progestin receptor in human benign prostatic hyperplasia and prostatic carcinoma. Invest Urol 15: 361–366, 1978PubMedGoogle Scholar
  26. 26.
    Hawkins EF, Nijs M, Brassine C, Tagnon HJ: Steroid receptors in the human prostate. I. Estradiol- 17-/3-binding in benign prostatic hypertrophy. Steroids 26: 458–469, 1975PubMedCrossRefGoogle Scholar
  27. 27.
    Hawkins EF, Trachtenberg J, Hicks LL, Walsh PC: Androgen and estrogen receptors in the canine prostate. J Androl 1: 234–243, 1980Google Scholar
  28. 28.
    Huggins C, Clark PC: Quantitative studies on prostatic secretion. II. The effect of castration and of estrogen injection on the normal and on the hyperplastic prostate gland of dogs. J Exp Med 72: 747–762, 1940PubMedCrossRefGoogle Scholar
  29. 29.
    Huggins C, Stevens RA, Hodges CV: Studies on prostatic cancer. II. Effects of castration on advanced carcinoma of the prostate gland. Arch Surg 43: 209–223, 1941Google Scholar
  30. 30.
    Jacobi GH, Altwein JE: Bromocriptine, ein neues therapeutisches Prinzip beim Prostata Adenom und Karzinom. Dtsch Med Wochenschr 103: 827–833, 1978PubMedCrossRefGoogle Scholar
  31. 31.
    Jönsson G, Olsson AM, Luttrop W, Cekan Z, Purvis K, Diszfalusy E: Treatment of prostatic carcinoma with various types of estrogen derivatives. Vitam Horm 33: 351–376, 1975PubMedCrossRefGoogle Scholar
  32. 32.
    Kledzik GS, Marshall S, Campbell GA, Gelato M, Meites J: Effects of castration, testosterone, estradiol and prolactin on specific prolactin-binding activity in ventral prostate of male rats. Endocrinology 98: 373–379, 1976PubMedCrossRefGoogle Scholar
  33. 33.
    Lerner LJ: Hormone antagonists: inhibitor of specific activities of estrogen and androgen. Recent Prog Horm Res 20: 435–490, 1964PubMedGoogle Scholar
  34. 34.
    Murphy JB, Emmott RC, Hicks LL, Walsh PC: Estrogen receptors in the human prostate, seminal vesicles, epididymis, testis, and genital skin: a marker for estrogen-responsive tissues? J Clin Endocrinol Metab 50: 938–948, 1980PubMedCrossRefGoogle Scholar
  35. 35.
    Neri RO, Casmer C, Zeman WV, Fielder F, Tabachnik IIA: Effects of an antiandrogen, SH 714 (6-chlor-A6-1,2a-methylen-17a-hydroxy progesterone acetate, cyproterone acetate) on canine prostatic hyperplasia. Endocrinology 82: 311–317, 1968CrossRefGoogle Scholar
  36. 36.
    Ohlsen H, Ekman P, Ringertz H: Assessment of prostatic size with computed tomography. Acta Radiol [Diagn] 23: 219–223, 1982Google Scholar
  37. 37.
    Pavone-Macaluso M, Lund F, Mulder JH, Smith PH, DePauw M, Sylvester R, EORTC Urological Group: EORTC protocols in prostatic cancer: an interim report. Scand J Urol Nephrol (Suppl) 55: 163–168, 1980Google Scholar
  38. 38.
    Pertschuk LP, Tobin EH, Tanapat P, Gaetjens E, Carter AC, Bloom ND, Macchi RJ, Byer Eisenberg K: Histochemical analyses of steroid hormone receptors in breast and prostatic carcinoma. J Histochem Cytochem 28: 799–810, 1980PubMedCrossRefGoogle Scholar
  39. 39.
    Purvis K, Brenner PF, Landgren BM, Cekan Z, Diczfalusy E: Indices of gonadal function in the human male: plasma levels of unconjugated steroids and gonadotropins under normal and pathological conditions. Clin Endocrinol (Oxf) 4: 237–246, 1975CrossRefGoogle Scholar
  40. 40.
    Raynaud JP, Bouton MM, Martin PM: Human prostate hyperplasia and adenocarcinoma: steroid hormone receptor assays and therapy. In Schroder FH, de Voogt HJ (eds.): Steroid Receptors, Metabolism and Prostatic Cancer. Excerpta Medica, Amsterdam, 1980, pp 165–181Google Scholar
  41. 41.
    Resnick MI, Walvoord DJ, Grayhack JT: Effect of prolactin on testosterone uptake by the perfused canine prostate. Surg Forum 25: 70–72, 1974PubMedGoogle Scholar
  42. 42.
    Rolland PH, Martin PM, Serment G, Roulier R, Rolland AM: Human benign prostatic hypertrophy: role of prostaglandin E2 and its relationship to bromocriptine therapy. Eur Urol 7: 41–45, 1981PubMedGoogle Scholar
  43. 43.
    Scott WW, Coffey DS: Non-surgical treatment of human benign prostatic hyperplasia. Vitam Horm 33: 439–465, 1975PubMedCrossRefGoogle Scholar
  44. 44.
    Scott WW, Wade JC: Medical treatment of benign nodular prostatic hyperplasia with cyproterone acetate. J Urol 101: 81–85, 1969PubMedGoogle Scholar
  45. 45.
    Skoldefors H, Blomstedt B, Carlstrom K: Serum hormone levels in benign prostatic hyperplasia. Scand J Urol Nephrol 12: 111–114, 1978PubMedCrossRefGoogle Scholar
  46. 46.
    Snochowski M, Pousette A, Ekman P, Bression D, Andersson L, Hogberg B, Gustafsson JA: Characterization and measurement of the androgen receptor in human benign prostatic hyperplasia and prostatic carcinoma. J Clin Endocrinol Metab 45: 920–930, 1977PubMedCrossRefGoogle Scholar
  47. 47.
    Trachtenberg J, Hicks LL, Walsh PC: Androgen- and estrogen-receptor content in spontaneous and experimentally induced canine prostatic hyperplasia. J Clin Invest 65: 1051–1059, 1980PubMedCrossRefGoogle Scholar
  48. 48.
    Tunn U, Senge Th, Schenk B, Neumann F: Effects of cyproterone acetate on experimentally induced canine prostatic hyperplasia. Urol Int 35: 125–140, 1980PubMedCrossRefGoogle Scholar
  49. 49.
    Wagner RK, Schulze KH, Jungblut PW: Estrogen and androgen receptor in human prostate and prostatic tumor tissue. Acta Endocrinol [Suppl] (Copenh) 193: 52–76, 1975Google Scholar
  50. 50.
    Walsh PC, Wilson JD: The induction of prostatic hypertrophy in the dog with androstanediol. J Clin Invest 57: 1093–1097, 1976PubMedCrossRefGoogle Scholar

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© Springer-Verlag New York Inc. 1983

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  • Peter Ekman

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