Stop Prostate Problems

Enlarged Prostate: Treatments, Risks

Urination Problem: Solutions

Benign Prostatic Hyperplasia ( BPH )

Medical Treatments

There are several treatment options for men with benign prostate hyperplasia, depending on the severity of symptoms. If symptoms do not threaten the man's health, he may choose not to be treated. If symptoms are severe enough to cause discomfort, interfere with daily activities, or threaten health, treatment is usually recommended.

- Watchful waiting

Men with mild symptoms may choose to return for annual examinations. The physician will perform an examination that includes a DRE, PSA tests, and a urinary flow rate. The patient will be asked to describe symptoms in order to determine if the condition is worsening.

- Medication

One of the more common and well-received BPH therapy is the medication treatment option

5-Alpha reductase inhibitors

5-Alpha reductase inhibitors such as Finasteride (Proscar®) and dutasteride (Avodart® shrink the enlarged prostate by decreasing dihydrotestosterone, the male hormone responsible for prostate growth. This gradually improves urine flow rate and decrease the symptoms of BPH. In many cases, a treatment period of 6-month is necessary to see if the therapy is going to work.

In the "Guidelines on Benign Prostatic Hyperplasia", published by the European Association of Urology, the therapeutic results of 5-alpha reductase inhibitors in patients with benign prostatic hyperplasia are summarized as follows:

• "It has been shown in numerous randomized, placebo-controlled clinical trials that 5-alpha reductase
  inhibitors are capable of reducing prostate volume and improving symptom scores and flow rates.
  Maximum benefits are seen at a mean period after 6 months.
• Men with small prostates (< 40 mL) are less likely to benefit from finasteride.
• 5-alpha reductase inhibitors can alter the natural history of symptomatic BPH by influencing
  prostatectomy and acute urinary retention rates. The costs of such protocols, however, should be
  further evaluated.
• The long-term (up to 10 years) effects of 5- alpha reductase inhibitors are substantial.
• The combination of a 5-alpha reductase inhibitor with an alpha-blocker seems beneficial according
  to the data currently available.
• Side-effects of 5-alpha reductase inhibitors are minimal
• Treatment with 5-alpha reductase inhibitors does not mask the detection of prostate carcinoma.
  By doubling PSA serum levels, an accurate estimation can be expected."

Finasteride is available in tablet form and taken orally, once a day. The recommended dosage is 5 mg per day.

Alpha blockers

Alpha blockers are drugs that relax smooth muscle tissue in the bladder neck and prostate, which increases urinary flow. They typically are taken orally, once or twice a day.

Commonly prescribed alpha blockers include the following:

- alfuzosin (UroXatral®), tablet taken once daily
- doxazosin (Cardura®), tablet taken once daily
- prazosin (Minipress®), capsule taken 2 or 3 times daily
- tamsulosin HCL (Flowmax®), capsule taken once daily
- terazosin (Hytrin®), capsule taken once daily

Patients taking an alpha blocker require follow-up during the first 3 or 4 weeks to evaluate the effect on symptoms and adjust the dosage, if necessary.

Side effects include headache, dizziness, low blood pressure, fatigue, weakness, and difficulty breathing. Long-term risks and benefits have not been studied.

- Prostatic stents

Although a prostatic stent is not a medical treatment, neither does it fall under the classification of a surgical procedure. Prostatic stents are used most often for patients with significant medical problems that prohibit medication or surgery. It is a tiny, springlike device inserted into the urethra. When expanded, it pushes back the surrounding tissue and widens the urethra.

Prostatic stents have several advantages:

- They can be placed in 15 min. under regional anesthesia.
- Bleeding during and after surgery is minimal.
- The patient can be discharged the same day

There are also several disadvantages:

- Prepositioning can be difficult.
- They may cause irritation and frequent urination.
- They may cause pain or incontinence.
- Removing them (necessary in1/3 of cases) can be difficult.

Disclaimer

The information contained herin is a summary and does not contain all possible information about this product / products. For complete information about this product / products or your specific health needs, ask your health care professional. Always seek the advice of your health care professional if you have any questions about this produ t/ products or your medical condition.

This information is not intended as individual medical advice and does not substitute for the knowledge and judgment of your health care professional. This information does not contain any assurances that this product / products is safe, effective, or appropriate for you.

 

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