Management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: the central role of the patient risk profile

Crawford, E. David

doi:10.1111/j.1464-410x.2005.05484.x

Cited by 8 publications

(3 citation statements)

References 32 publications

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“…As discussed by Crawford [1], treatment of chronic diseases such as LUTS suggestive of BPH should relieve symptoms and improve quality of life (QoL). Stopping or delaying disease progression is another major treatment goal.…”

Section: Introductionmentioning

confidence: 99%

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α₁‐adrenoceptor antagonists

2005

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SUMMARY An update of a systematic review of α1‐adrenoceptor (AR) antagonists in the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) showed that these agents have comparable efficacy. The total symptom score is improved by 30–45% and maximum urinary flow rate by 15–30% vs baseline. α1‐AR antagonists that can be started at their therapeutic dose have a more rapid onset of action than α1‐AR antagonists that have to be titrated. α1‐AR antagonists can be differentiated according to their tolerability. Alfuzosin (especially the 10 mg once daily dose) and tamsulosin (especially the 0.4 mg once daily dose) are better tolerated than doxazosin and terazosin. However, alfuzosin might induce more cardiovascular adverse events (AEs) in the elderly and/or patients with cardiovascular comorbidity and/or comedication. Tamsulosin tends to interfere less with blood pressure regulation and induce less vasodilatory AEs than alfuzosin, especially in the elderly, and is well tolerated in patients with cardiovascular comorbidity and/or comedication. Cardiovascular AEs might lead to potentially serious complications such as falls, fractures and institutionalization. Abnormal ejaculation has mainly been reported in placebo‐controlled trials with tamsulosin but in direct comparative trials its rate with tamsulosin 0.4 mg was similar to, or only slightly higher than, the rate with alfuzosin. In addition, abnormal ejaculation is not reported as bothersome by the patient or associated with serious complications. It can be concluded that an α1‐AR antagonist with a low potential to interfere with blood pressure regulation and to induce cardiovascular AEs, also in patients with cardiovascular comorbidity and/or comedication, can be considered a first‐choice treatment option in LUTS/BPH.

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Section: Introductionmentioning

confidence: 99%

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α₁‐adrenoceptor antagonists

2005

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“…The concept that BPH is a progressive disease has been widely accepted [8][9][10] and several studies have provided evidence to confirm this theory. AUR can be regarded as an ultimate end point of this progression because it requires prompt medical intervention.…”

Section: Benign Prostatic Hyperplasia Progressionmentioning

confidence: 91%

Acute urinary retention: Who is at risk and how best to manage it?

Patel

Chapple

2006

Curr Urol Rep

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In recent years, we have begun to understand the progressive nature of benign prostatic hyperplasia. By careful analysis of population studies and clinical trials, we can determine the factors most likely to predict progression to one of its most distressing complications, acute urinary retention. Acute urinary retention is a common urologic emergency and causes significant suffering, although rarely has it any serious consequences. Using our knowledge regarding the progression of benign prostatic hyperplasia, new treatment modalities are being assessed for their effectiveness at halting progression and ultimately preventing this distressing condition.

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“…Based on systematic reviews, tamsulosin and once daily preparations of extended release alfuzosin have the lowest risk of cardiovascular adverse events and are suitable as first line agents, especially in high risk and elderly patients 12. The other α antagonists are appropriate for younger patients or those unlikely to have cardiovascular side effects.…”

Section: α Antagonistsmentioning

confidence: 99%

BMJ Learning : Benign prostatic hyperplasia: treatment in primary care

Patel

Chapple

2006

BMJ

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Management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: the central role of the patient risk profile

Cited by 8 publications

References 32 publications

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α₁‐adrenoceptor antagonists

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α₁‐adrenoceptor antagonists

Acute urinary retention: Who is at risk and how best to manage it?

BMJ Learning : Benign prostatic hyperplasia: treatment in primary care

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Management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: the central role of the patient risk profile

Cited by 8 publications

References 32 publications

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α1‐adrenoceptor antagonists

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α1‐adrenoceptor antagonists

Acute urinary retention: Who is at risk and how best to manage it?

BMJ Learning : Benign prostatic hyperplasia: treatment in primary care

Contact Info

Product

Resources

About

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α₁‐adrenoceptor antagonists

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α₁‐adrenoceptor antagonists