Dutasteride for Improving Peri-Operative and Long-Term Outcomes of Photoselective Vaporization of the Prostate (DOP)

Inclusion Criteria: 1. Men aged ≥ 50 years old 2. Subjects with LUTS due to BPH with: AUA SI score ≥ 12 at baseline Qmax ≤ 15 mL/sec (on at least 125 mL) Symptoms for ≥ 3 months 3. Subjects with prostate volume ≥ 30 grams 4. Subjects who are appropriate surgical candidates for Photoselective Vaporization of the Prostate (PVP) as determined by a study investigator 5. Subjects able to swallow and retain oral medication 6. Subjects able to comply with study protocol 7. Subjects able to read and write (to complete the self-administered AUA SI) 8. Subjects who sign the approved Informed Consent Form for the study Exclusion Criteria: Subjects who have previously undergone a surgical treatment for BPH including but not limited to TURP, TUNA, TUIP, thermotherapy, prostatic stent, dilation balloon, etc. Subjects with a history of prostate cancer Subjects with a history of bladder or testicular cancer in the past 5 years  Subjects who have been cancer-free for at least 5 years will be eligible  Subjects with a history of superficial bladder cancer will not be excluded Subjects who have received radiation to the pelvis or prostate or radical surgery to the pelvic area Subjects with persistent gross hematuria, current symptomatic prostatitis Subjects with neurogenic bladder and/or sphincter abnormalities for any reason including Parkinson's disease, multiple sclerosis, stroke, or diabetes Subjects who have used any 5 α-reductase inhibitors in the past 3 months.  Subjects who wash-out of these medications for 3 months prior to screening will be eligible Subjects taking alpha-blockers within 2 weeks prior to randomization.  Subjects must be off of alpha blockers at the time of randomization for the measurement of AUA Symptom Score, QoL Score, flow rate, post void residual, etc. In the rare case a patient goes into retention during the 3 month period between randomization and PVP, they will be allowed to resume their alpha blocker until the PVP since no outcomes are measured during this period. They will be required to discontinue the alpha blocker after they have surgery Subjects on an unstable regimen of antidepressants, anticholinergics, androgens, or herbal supplements including phyto-sterols (such as saw palmetto)  Subjects who are on a stable regimen of the above medications for at least 1 month prior to screening and are willing to stay on the same dose for the duration of the study will be eligible Subjects on an unstable regimen of beta-blockers, antihistamines, anticonvulsants, antispasmodics, or other medications known to affect the clinical symptoms of BPH  Subjects who are on a stable regimen of the above medications for at least 4 months prior to screening and are willing to stay on the same dose for the duration of the study will be eligible Subjects with a post void residual > 350 mL Subjects with a known hypersensitivity to 5α-reductase inhibitors PSA > 10  Subjects with a PSA between 4 and 10 with a negative prostate biopsy and deemed at low risk for prostate cancer by the investigator Subjects with serum creatinine >1.5 x the upper limit, ALT > 2 x the upper limit, AST > 2 x the upper limit, ALP > 2 x the upper limit, or bilirubin > 1.5 x the upper limit for normal Subjects treated in the last 30 days with another investigational product or currently participating in another study with an investigational drug or procedure Subjects deemed ineligible for the study by the site investigators or the sponsor -