Drugs for benign prostatic hypertrophy

Abstract

Benign prostatic hyperplasia is a common condition. It can cause problems with urine storage and voiding, and the severity of symptoms may be unrelated to the size of the prostate. When drug treatment is required, benign prostatic hyperplasia can be managed with monotherapy or combination therapy. Most patients are managed with selective alpha blockers. Patients with larger prostate volumes may benefit from a 5-alpha-reductase inhibitor, usually in combination with an alpha blocker. Medical therapy for benign prostatic hypertrophy largely works by reducing dynamic and static components. In the last decade, clinical trials have shown that drug therapy is beneficial, however the currently available drugs vary in their efficacy depending on the patient's profile. Alpha blockers Alpha 1a adrenergic receptor inhibition with selective (tamsulosin, silodosin, terazosin, alfuzosin) or non-selective (prazosin) drugs treat the dynamic component of benign prostatic hyperplasia by relaxing smooth muscle in the prostate and bladder neck. This causes the urethral lumen to widen so improving urinary flow. 3 Alpha blockers can improve symptoms and increase the maximal urinary flow rate. 3,5,9-12 Adverse effects Although systemic adverse effects are less frequent with the more selective alpha blockers, they increase the risk of ejaculatory dysfunction. 3 Other adverse effects of alpha blockers include retrograde Manasi Jiwrajka Resident medical officer 1

A comparative clinical evaluation of outcome of medical and surgical management of symptoms due to benign prostatic hyperplasia

“…This finding is supported by the work Huang Shei-Wei et al and Macey et al 11,12 Dizziness and postural hypotension are most common adverse drug reaction in both medical management group medical but urinary incontinence and decreased libido was common in silodosin and dutasteride. This finding is supported by the work of Zaman Huri et al and Jiwrajka et al 14,15 In our study we have observed that quality of life score was improved in all three group but the improved in QOL for TURP group was better than medical management.…”

Neferine improves oxidative stress and apoptosis in benign prostate hyperplasia via Nrf2-ARE pathway.

“…Ablative surgery, α Blockers, 5-α Reductase inhibitors (5-ARIs), and a combination of α blockers and 5-ARIs have been inaugurated to treat BPH condition [ 28 ] but also presents the risk of ejaculatory dysfunction, hypotension, tachycardia, decreased semen count [ 29 ]. So, at present effective treatable drug is still unattained.…”

Management of benign prostatic hyperplasia in the 21st century: temporal trends in Australian population‐based data

“…BPH and resultant LUTS affect men as they age, which adversely impacts on their quality of life [1][2][3]. Currently recommended treatment options include watchful waiting, medical therapy and surgery [4][5][6]. Medical therapy for LUTS secondary to BPH encompasses a wide range including 5areductase inhibitors (5ARIs), a-blockers (ABs), antimuscarinics, b 3 -agonists, and phosphodiesterase type 5 inhibitors.…”