TREATMENT OF BENIGN PROSTATIC HYPERTROPHY WITH ESTROGEN ADMINISTERED INTRAVENOUSLY: Report of Seventeen Cases

Estrogenic Management of Benign Prostatism, Including Early and Poor‐risk Cases: 7‐year Experience*

“…In cases of longstanding prostatism aggravated by the combination of heart failure and diuretic medication, the ability to void the increased quantities of urine was enhanced. Considerable relief of troublesome nocturia (when other medical and urologic disorders were excluded) also was frequently afforded by estrogenic therapy, an experience reported by others ( 4,12,14). Decompression of a distended urinary bladder was verified in several patient,; by determining the residual volume before and after ICEE (see Cases 4 and 14 under Case Reports).…”

“…I do not want or pretend to replace prostatectomy by hormonal treatment; I do not even think that oestrogens can change the course of the disease, but given intermittently they certainly can offer a patient a great deal of relief when prostatectomy is not indicated or is refused by the patient. Given permanently to an inoperable patient, they can occasionally avoid the need for an indwelling catheter.” Ende and Jacobson (12) administered Premarin orally and intravenously on an out‐patient basis to 17 patients, with benefit. They were considered to be “poor surgical risks because of recent myocardial infarction, congestive heart failure and general debilitation.…”

“…The issue of androgenic aggravation of prostatic hyperplasia and neoplasia remains unsettled . As ordinarily administered, testosterone probably does not cause or stimulate the growth of prostatic carcinoma (12, 55). Similarly the judicious supplementary use of testosterone or its analogues for their “tonic geriatric effect” is generally innocuous.…”

“…3. Ende and Jacobson (12) administered Premarin orally and intravenously on an out-patient basis to 17 patients, with benefit. They were con:;idercd to be "poor surgical risks because of recent myocardial infarction, congestive heart failure and general debilitation.…”

“…The drug was taken after breakfast in order to avoid nausea, and was usually tolerated well. Ende and Jacobson (12) recommended the combination of ICEE (20 mg) for four days and relatively large amounts of Premarin orally (1.25 mg three times daily), in the belief that the peak hormonal effect was not obtained until after four weeks. In the present study, however, fewer injections of ICEE and smaller oral dosages usually proved satisfactory.…”