Medication Summary. The goals of pharmacotherapy for benign prostatic hypertrophy (BPH) are to reduce morbidity and to prevent complications. The agents used include alpha-adrenergic blockers, 5-alpha-reductase inhibitors, phosphodiesterase-5 enzyme inhibitors, and various combinations.
How do medications treat benign prostatic hyperplasia (BPH)?
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.
Why do drugs that treat BPH worsen symptoms?
Oct 01, 2018 · 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 ...
Which combination medications are used in the treatment of prostate cancer?
9 rows · Dec 04, 2020 · Drugs approved for the treatment of BPH symptoms are: darifenacin hydrobromide (darifenacin), ...
Should 5-alpha-reductase inhibitors be used to treat benign prostatic hyperplasia?
Another class of drugs used for treating BPH is the alpha-1-adrenergic receptor blockers (alpha blockers), which act by relaxing the smooth muscle of the prostate and bladder neck to improve urine flow and reduce bladder outlet obstruction.. This class includes terazosin, doxazosin, tamsulosin, and alfuzosin. .
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.Mar 1, 2008
What is the best treatment for BPH?
One of the most effective holmium laser treatments for BPH is a procedure called Holmium Laser Enucleation of the Prostate (HoLEP). It is an effective option for patients who have large prostates and/or other health problems that can make surgery more complicated.Feb 27, 2018
Which drug used in the treatment of benign prostatic hypertrophy is most likely to cause postural hypotension?
Studies have also shown that prazosin has an average discontinuation rate of 17%, due to systemic adverse effects such as dizziness and headaches, presumably caused by postural hypotension.Oct 1, 2018
Which of the following is a drug that decreases the symptoms of benign prostatic hypertrophy?
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.
What is Flomax used for?
Tamsulosin is used by men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It does not shrink the prostate, but it works by relaxing the muscles in the prostate and the bladder.
What are alpha blockers used for?
Alpha blockers are a type of blood pressure medication. They lower blood pressure by preventing a hormone called norepinephrine from tightening the muscles in the walls of smaller arteries and veins. As a result, the blood vessels remain open and relaxed. This improves blood flow and lowers blood pressure.
How do alpha blockers treat BPH?
BPH alpha blockers relax the prostate and bladder neck muscles by blocking alpha1 adrenoreceptors, protein molecules that stimulate muscle contraction when activated by the hormones, epinephrine, and norepinephrine.
What drug reduces size of prostate?
5-alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth. These medications — which include finasteride (Proscar) and dutasteride (Avodart) — might take up to six months to be effective. Side effects include retrograde ejaculation.
Is prazosin used for enlarged prostate?
Prazosin is well known to most physicians as an effective antihypertensive medication, but its therapeutic value in many cases of benign prostatic hyperplasia (BPH) may be unfamiliar to many.
How does prazosin treat BPH?
Prazosin (Minipress) Prazosin improves urine flow rates by relaxing smooth muscle. Relaxation is produced by blocking alpha-1 adrenoreceptors in the bladder neck and prostate. The advantage of prazosin over nonselective alpha-adrenergic blockers includes a lower incidence of adverse effects.Feb 19, 2021
What is the best treatment for urinary retention?
Alpha-blockers + 5-alpha-reductase inhibitors. Alpha-blockers + 5-alpha-reductase inhibitors can further increase improvement in lower urinary tract symptoms and Qmax, so long as increased rates of adverse effects are accepted, and can also reduce the risk of acute urinary retention and the need for surgery.
What is BPO in LUTS?
In affected patients, BPO causes various lower urinary tract symptoms (LUTS) which in terms of the differential diagnosis can occur in various diseases, especially diseases of the bladder (e.g., overactive bladder, bladder carcinoma, cystitis), complicating identification of the symptoms and their cause.
How many men have LUTS?
The course and severity of these symptoms can vary greatly.. They mainly affect older men, with prevalence increasing with age: on average, 50% of men over 60 years of age and 80% of men over 80 years of age experience LUTS caused by BPH (2– 4).
Is PSA a predictor of prostate growth?
PSA level, unless influenced by other pathologic processes, correlates with prostate volume (20) and is a strong predictor of prostate growth (21). In addition, baseline PSA is a predictor of risk of urinary retention and surgical risk (16, 17). However, there is no known direct association between BPH and prostate cancer (22), ...
What is BPH in a woman?
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). See also: sub-topics.
What is an EUA?
EUA. An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives. Pregnancy Category. A.
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH) refers to the proliferation of epithelial and smooth muscle cells within the transition zone of the prostate. Other terms for BPH include benign prostatic hypertrophy and benign prostatic enlargement (BPE). The term has been used to describe a constellation of voiding symptoms that occurs in men with aging. These symptoms are generally referred to as obstructive in nature, as the hyperplastic tissue leads to a narrowing of the prostatic urethra. Such symptoms include decreased force of stream, hesitancy, straining, incomplete bladder emptying, and nocturia. Irritative symptoms are also associated with BPH and include urinary frequency, urgency, and occasionally dysuria.
What is prostate specific antigen?
Prostate Specific Antigen (PSA) is a serine protease produced by benign and malignant prostate tissue. Functionally, PSA is the enzyme responsible for liquefaction of the seminal fluid after ejaculation. Although produced in small amounts in other tissues, it should be considered to be prostate specific. PSA circulates in the serum in both free (unbound) and complexed (bound) forms. In addition to being elevated by BPH and prostate cancer, PSA may also be transiently elevated in cases of prostatic inflammation (prostatitis) or infarction, and after prostatic manipulation by biopsy. However, routine digital rectal examination (DRE) usually has little effect on serum PSA levels. The half-life of serum PSA is 2.2 to 3.2 days. Therefore, one should wait 4 to 8 weeks after prostate manipulation and inflammation (cystoscopy, prostate biopsy, and prostatitis) before obtaining a PSA.
What are the two zones of interest in prostate cancer?
The prostate is composed of several regions and zones: two zones of interest are the peripheral zone, where most cancers arise, and the transition zone, where BPH arises.
What is a TURP procedure?
In this type of surgery, no external incision is needed. After giving anesthesia, the surgeon reaches the prostate by inserting an instrument called a resectoscope through the urethra. The resectoscope is about 12 inches long and 1/2 inch in diameter, contains a light, valves for controlling irrigating fluid, and an electrical loop that cuts tissue and seals blood vessels. During the 60-90-minute operation, the surgeon uses the scope's wire loop to remove the obstructing tissue one piece at a time. The pieces of tissue are carried by the fluid into the bladder and then flushed out at the end of the operation. A TURP is used for approximately 90% of all prostate surgeries for BPH. In most patients, before TURP is performed, consideration has already been given to medical therapy. In general, TURP is reserved for very symptomatic men or those who develop complications including urinary tract infection, bladder stones, or gross hematuria as mentioned above.
What is the best treatment for BPH?
Alfuzosin is indicated for the treatment of the signs and symptoms of BPH. Alfuzosin is an alpha-1 blocker of adrenoreceptors in the prostate. Blockade of adrenoreceptors may cause smooth muscles in the bladder neck and prostate to relax, resulting in improvement in urine flow rate and reduction in symptoms of BPH. Indoramin.
Where is the prostate located?
Normal prostate anatomy is shown. The prostate is located at the apex of the bladder and surrounds the proximal urethra. Benign prostatic hyperplasia (BPH) diagnosis and treatment algorithm. Benign prostatic hyperplasia.
What is phenoxybenzamine?
Phenoxybenzamine is a nonselective alpha-adrenergic receptor blocker that antagonizes both alpha-1 and alpha-2 receptors.
Does doxazosin affect blood pressure?
It inhibits postsynaptic alpha-adrenergic receptors, resulting in vasodilation of veins and arterioles and a decrease in total peripheral resistance and blood pressure. It is a long-acting alpha1-blocking agent with a profile similar to that of terazosin. Doxazosin improves irritative and obstructive voiding symptoms.
Does Tadalafil help with BPH?
Sexual stimulation is necessary to activate response. Tadalafil has been approved by the FDA for the treatment of BPH signs and symptoms. PDE5 inhibition has been shown to induce smooth muscle relaxation in the lower urinary tract. It has also been approved for the treatment of simultaneous BPH and ED.
What is a doxazosin?
Doxazosin improves irritative and obstructive voiding symptoms. Tamsulosin (Flomax) View full drug information. Tamsulosin is indicated for the treatment of the signs and symptoms of BPH. It is an alpha-adrenergic blocker specifically targeted to alpha-1 receptors.
Does Silodosin help with BPH?
Silodosin is indicated for the treatment of the signs and symptoms of BPH. Silodosin selectively antagonizes postsynaptic alpha1-adrenergic receptors in the prostate, bladder base, prostatic capsule, and prostatic urethra. This action induces smooth muscle relaxation and improves urine flow. Previous.
What is the BPH of the prostate?
BPH is a condition of the prostate gland. The prostate is under the bladder and in front of the rectum. It’s part of the male reproductive system. The main job of the prostate is to contribute fluid to semen.
What is the best medicine for a swollen bladder?
Antihistamines, such as diphenhydramine ( Benadryl ), are often used to treat allergic reactions. These medications prevent the bladder muscle from contracting, which can slow or inhibit the flow of urine.
What are the benefits of diuretics?
Diuretics help remove extra fluid in your body by pulling more water out of your bloodstream into the urine. These drugs are used to treat conditions such as: 1 high blood pressure 2 heart failure 3 liver disease 4 glaucoma
How to stop urinate at night?
Be careful about how much fluid you consume. The more you drink, the more you’ll feel the urge to urinate. Stop drinking water and other fluids a few hours before you go to bed. You’ll have less chance of being awakened in the middle of the night by an urgent need to use the restroom.
Can NSAIDs cause urinary retention?
On the one hand, some studies have found they shrink the prostate and improve urinary symptoms. On the other hand, research shows some NSAIDs can worsen urinary retention.
What happens to the prostate as you get older?
As it enlarges, the prostate squeezes on the urethra where it passes through the prostate gland. The urethra is the tube through which urine passes from the bladder out of the body.
What causes a person to pee more?
Diuretics cause your body to release more urine. Avoid drinks that may have a diuretic effect. These include: alcohol. coffee. soda. other caffeinated beverages. Avoiding or reducing intake of certain foods, such as dairy and meat, may also help your prostate health improve.