Medication
Two main types of medicines are available to treat BPH. One type relaxes the smooth muscle in the prostate and the other kind decreases the amount of hormone that stimulates prostate growth. Symptoms of BPH can also be relieved by antimuscarinics, a group of drugs that work to relax bladder contractions.
Procedures
Other names: Benign Prostatic Enlargement; Benign Prostatic Hypertrophy; BPH; Enlarged prostate; Prostate, enlarged About Benign Prostatic Hyperplasia: BPH is a condition where benign (non-cancerous) nodules enlarge the prostate gland (the gland that produces the liquid in which sperm are expelled from the penis).
Nutrition
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 Keywords: alpha blockers, 5-alpha-reductase inhibitors, benign prostatic hyperplasia Introduction
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In men with larger prostate volumes, combination therapy with an alpha blocker and 5-alpha-reductase inhibitor has been shown to have increased efficacy. Patients must be informed about the adverse effect profile of these drugs to make a collaborative and holistic decision about which drug to use.
How do medications treat benign prostatic hyperplasia (BPH)?
What is benign prostatic enlargement (BPH)?
Should 5-alpha-reductase inhibitors be used to treat benign prostatic hyperplasia?
Which drugs are best for prostate cancer treatment?
What is first-line drug therapy for benign prostatic hypertrophy BPH )?
Alpha blockers are recommended as first-line treatment for BPH, except for prazosin (Minipress) and phenoxybenzamine (Dibenzyline), which lack data to support their use and, therefore, are not recommended. The 5-alpha reductase inhibitors are only recommended in men with documented prostate enlargement.
Which class of drugs are most commonly used to treat BPH?
In the last decade, selective alpha blockers have become the mainstay of drug therapy for uncomplicated benign prostatic hypertrophy. In the absence of contraindications, the first-line therapy for all men is an alpha blocker.
What is the best treatment for benign prostatic hyperplasia?
The gold standard for the management of BPH is surgical treatment by transurethral resection of the prostate (TURP). However, in older adults, medical therapy is preferred to surgical intervention when possible.
What drug is used in the treatment of both benign prostatic hypertrophy and erectile dysfunction?
About Cialis Cialis for once daily use is approved to treat ED, the signs and symptoms of BPH, and ED and the signs and symptoms of BPH in men who have both conditions (ED+BPH). Only the 5 mg dose is approved to treat BPH and ED+BPH.
Which of the following medication can be used to treat hypertension and benign prostatic hypertrophy?
The alpha blockers that are most commonly used for the treatment of enlarged prostate symptoms are: alfuzosin. doxazosin. silodosin.
Which drug used in the treatment of benign prostatic hypertrophy is most likely to cause postural hypotension?
APPROACHES TO BPH PHARMACOTHERAPY Terazosin is effective in the management of patients with BPH, but the combination of terazosin and other antihypertensive agents has been shown to cause clinically significant hypotension.
Which is better alfuzosin or tamsulosin?
Among the patients who were able to void successfully, both drugs improved the prostatic symptom score, decreased the post-void residual urine volume, and improved the peak flow rate. Tamsulosin was found to be as effective as alfuzosin in all these parameters, except for sexual side effects.
What is tamsulosin used for?
Tamsulosin helps reduce the symptoms of an enlarged prostate gland by relaxing the muscles in the bladder and prostate so you can pee more easily. When you first take tamsulosin, it may make you feel dizzy or lightheaded. If this happens it's best to sit or lie down until your feel better.
What is finasteride used for?
Finasteride is used to treat men with an enlarged prostate (benign prostate enlargement). It can help ease your symptoms if: it's difficult to start peeing.
How do alpha blockers treat BPH?
Alpha blockers — These medications relax the muscle of the prostate and bladder neck, which allows urine to flow more easily.
Does sildenafil treat BPH?
Both Flomax (generic name tamsulosin) and Viagra (generic name sildenafil) are medications prescribed to treat symptoms of benign prostatic hyperplasia (BPH), which causes an enlarged prostate.
Which is better for BPH Flomax or Cialis?
Cialis is a good option for men with both BPH and ED. Flomax is primarily for BPH. Both of these drugs can cause a drop in blood pressure and wouldn't be a good choice for you if you already have low blood pressure or if your blood pressure varies.
What is the best treatment for BPH?
Two main types of medicines are available to treat BPH. One type relaxes the smooth muscle in the prostate and the other kind decreases the amount of hormone that stimulates prostate growth. Symptoms of BPH can also be relieved by antimuscarinics, a group of drugs that work to relax bladder contractions.
What is the best medicine for prostate cancer?
Finasteride. Dutasteride. Finasteride and dutasteride prevent the formation of the male hormone dihydrotestosterone, which is responsible for the growth of the prostate. These medicines may reduce your symptoms and improve your ability to urinate. Finasteride may also reduce your risk of needing surgery.
Can you use alpha blockers with dihydrotestosterone?
Research has shown that using alpha-blockers with dihydrotestosterone reducers may work better than using either drug alone in men with larger prostates. This type of therapy, called combination therapy, can decrease the development of complications and the need for surgical intervention. For instance, Jalyn is a medicine that contains both tamsulosin and dutasteride, a dihydrotestorone reducer.
Does tamsulosin cause low blood pressure?
Therefore, they are less likely to cause low blood pressure or fainting, although these adverse effects can still occur.
Can sleeping pills cause a bad urine flow?
Special Considerations. Certain over the counter medicines, notably antihistamines and sleeping pills that contain alpha-adrenergic products, and several kinds of pre scription medicines can cause a worsening of urine flow. These medicines can even lead to complete urinary obstruction in patients with BPH.
Does tadalafil help with BPH?
The US Food and Drug Administration (FDA) has recently approved tadalafil as a treatment for BPH, as well. The medicine can reduce symptoms, like difficulty starting to urinate, weak urination stream, and the urge to urinate frequently.
What is the best treatment for prostate hypertrophy?
The 5-alpha-reductase inhibitors reduce the progression of benign prostatic hypertrophy, manifested as acute urinary retention or the need for surgery.21Compared to alpha blockers, dutasteride and finasteride are more effective in men with larger prostate volumes (>40 mL) or prostate specific antigen (PSA) concentrations above 1.4 ng/mL.19-21Finasteride or dutasteride monotherapy is likely to have minimal to no difference for the I-PSS and urinary flow rates compared to placebo among men with prostate volumes less than 40 mL.8,21-23Overall the changes in I-PSS and flow rate are less than those with alpha blockers.3
What is benign prostatic hyperplasia?
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
What is Alpha1A inhibitor?
Alpha1a 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.3Alpha blockers can improve symptoms and increase the maximal urinary flow rate.3,5,9-12
What is tamsulosin used for?
Tamsulosin is a selective blocker for the alpha1a receptor subtype. It is available in a slow-release formulation, which reduces the systemic adverse effects such as postural hypotension and the need for dose titration.12Tamsulosin is a commonly prescribed drug in Australia but reimbursement is only covered by the Repatriation Pharmaceutical Benefits Scheme.
What enzyme converts testosterone to dihydrotestosterone?
The enzyme 5-alpha-reductase converts testosterone to dihydrotestosterone in the prostate.16Inhibition of this enzyme reduces androgenic dihydrotestosterone and subsequently reduces prostatic tissue volume and the static contribution to symptoms.3,17-19Dutasteride inhibits both the type 1 and type 2 isoenzymes of 5-alpha-reductase, while finasteride only inhibits the type 2 isoenzyme.20
What is phosphodiesterase 5 inhibitor?
Phosphodiesterase-5 inhibitors are more commonly used to treat erectile dysfunction. They can be effective in the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia, however they are less effective than alpha blockade therapy according to measures such as I-PSS and maximum urinary flow rate.32Phosphodiesterase-5 inhibitors reduce smooth muscle tone in the detrusor, prostate and urethra by increasing intracellular cyclic guanosine monophosphate.3As erectile dysfunction is a common adverse effect of 5-alpha-reductase inhibitors, they are sometimes used in combination to counteract it and also to reduce lower urinary tract symptoms.33
What is a referral for urology?
Urological referral is indicated for patients who have ongoing symptoms despite medical therapy. It is also indicated for complications including hydronephrosis, deteriorating kidney function, recurrent urinary tract infections, progressive deterioration of residual volume or macroscopic haematuria.
What is the best treatment for prostate hypertrophy?
The 5-alpha-reductase inhibitors reduce the progression of benign prostatic hypertrophy, manifested as acute urinary retention or the need for surgery. 21 Compared to alpha blockers, dutasteride and finasteride are more effective in men with larger prostate volumes (>40 mL) or prostate specific antigen (PSA) concentrations above 1.4 ng/mL. 19-21 Finasteride or dutasteride monotherapy is likely to have minimal to no difference for the I-PSS and urinary flow rates compared to placebo among men with prostate volumes less than 40 mL. 8, 21-23 Overall the changes in I-PSS and flow rate are less than those with alpha blockers. 3
What is the best treatment for benign prostatic hyperplasia?
Alpha blockers. Alpha1a 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.
How does prostatic hypertrophy work?
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.
What enzyme converts testosterone to dihydrotestosterone?
The enzyme 5-alpha-reductase converts testosterone to dihydrotestosterone in the prostate. 16 Inhibition of this enzyme reduces androgenic dihydrotestosterone and subsequently reduces prostatic tissue volume and the static contribution to symptoms. 3, 17-19 Dutasteride inhibits both the type 1 and type 2 isoenzymes of 5-alpha-reductase, while finasteride only inhibits the type 2 isoenzyme. 20
What is phosphodiesterase 5 inhibitor?
Phosphodiesterase-5 inhibitors are more commonly used to treat erectile dysfunction. They can be effective in the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia, however they are less effective than alpha blockade therapy according to measures such as I-PSS and maximum urinary flow rate. 32 Phosphodiesterase-5 inhibitors reduce smooth muscle tone in the detrusor, prostate and urethra by increasing intracellular cyclic guanosine monophosphate. 3 As erectile dysfunction is a common adverse effect of 5-alpha-reductase inhibitors, they are sometimes used in combination to counteract it and also to reduce lower urinary tract symptoms. 33
What is a referral for urology?
Urological referral is indicated for patients who have ongoing symptoms despite medical therapy. It is also indicated for complications including hydronephrosis, deteriorating kidney function, recurrent urinary tract infections, progressive deterioration of residual volume or macroscopic haematuria.
Can prostatic hyperplasia cause voiding?
SUMMARY. 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.
