Benign Prostatic Hyperplasia
- Diagnosis, Imaging, Screening
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- Internet Sites
- Risk Factors
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Benign Prostatic Hyperplasia
Daily Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Drug Side-Effects and Interactions
Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications. (Int J Impot Res. 2007)
Drugs
Comparing the therapeutic outcome of different alpha-blocker treatments for BPH in the same individuals. (Int Urol Nephrol. 2007 ) “CONCLUSION: Different alpha-blockers, which are used during different time frames in the same individuals, provide similar efficiency outcome. When the desired effect in the treatment for BPH could not be obtained with one alpha-blocker, there may not be any benefit in switching to another one.”
[Recent progress in the medical treatment of benign prostatic hyperplasia] (Prog Urol. 2007)
Dutasteride significantly improves quality of life measures in patients with enlarged prostate. (Prostate Cancer Prostatic Dis. 2007)
A review of combination therapy in patients with benign prostatic hyperplasia. (Clin Ther. 2007) "CONCLUSIONS:: The available data suggest that combination alpha(1)ARA/5ARI therapy is beneficial in the treatment of BPH and the associated symptoms. The greatest efficacy was evident in patients with an enlarged prostate, more severe symptoms, and higher PSA levels. There are limited data suggesting that the presence of prostatic inflammation may indicate a greater likelihood of treatment efficacy with combination therapy."
[Benign prostate hyperplasia : Success and limitations of pharmacological therapy.] (Internist (Berl). 2007)
The Long-Term Outcome of Medical Therapy for BPH. (Eur Urol. 2007)
A review of the clinical efficacy and safety of 5alpha-reductase inhibitors for the enlarged prostate. (Clin Ther. 2007) " BACKGROUND:: Enlargement of the prostate is common among aging men, with an incidence of 90% by the age of 85 years. It is a progressive condition, with growth in prostate size accompanied by lower urinary tract symptoms that can result in long-term complications (eg, acute urinary retention [AUR], need for enlarged prostate-related surgery). Current pharmacologic treatment options include alpha-blockers (alfuzosin, doxazosin, tamsulosin, and terazosin) and 5alpha-reductase inhibitors (5ARIs) (finasteride and dutasteride)."
A large retrospective analysis of acute urinary retention and prostate-related surgery in BPH patients treated with 5-alpha reductase inhibitors: dutasteride versus finasteride. (Am J Manag Care. 2007) " CONCLUSTION: Although the 2 drugs, dutasteride and finasteride, belong to the same category of 5ARIs, this large retrospective multivariate analysis potentially indicates differences in therapeutic outcomes. In this study, patients treated with dutasteride were less likely to experience AUR and demonstrated a trend toward being less likely to experience surgery than patients treated with finasteride."
Exercise
General Information
Natural course of lower urinary tract symptoms following discontinuation of alpha-1-adrenergic blockers in patients with benign prostatic hyperplasia. (Int J Urol. 2007) "Conclusions: In spite of the short follow-up periods, these results suggest that selected patients with relatively small prostatic volume and good flow rates after therapy can discontinue alphab medication after their symptoms improve."
Managing the progression of lower urinary tract symptoms/benign prostatic hyperplasia: therapeutic options for the man at risk. (BJU Int. 2007)
Advances in the medical management of benign prostatic hyperplasia. "Until the early 1990s, lower urinary tract symptoms were usually treated with transurethral resection of the prostate. However, as the natural history of BPH became better understood and the drugs available more selective, expectant management (for men with mild symptoms) and pharmacotherapy (moderate to severe symptoms) have been widely embraced. The benefits of symptomatic improvement, such as better urinary flow, symptom relief and improved quality of life, have been well documented in randomized clinical trials.2 Nevertheless, uncertainty has persisted about the effects of these therapies on the complications of BPH, which include urinary retention, refractory hematuria, bladder calculi, recurrent urinary tract infections and renal failure. … The 2 major classes of drugs used to treat BPH are -adrenergic antagonists or -blockers (doxazosin, terazosin, tamsulosin and alfluzosin) and 5- -reductase inhibitors (finasteride and dutasteride). Alpha-blockers relax the smooth muscle fibres of the bladder neck and prostate, thereby reducing the dynamic components of prostatic obstruction. Five- - reductase inhibitors decrease levels of intracellular dihydrotestosterone (the major growth-stimulatory hormone in prostate cells) without reducing testosterone levels. This leads to prostatic size reduction of 20%–30%.3 Symptom relief occurs within 2 weeks of initiating -blockers, compared with several months with finasteride."
Evidence-based guidelines for the management of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary. (Curr Med Res Opin. 2007) "Main findings/recommendations: Given the prevalence of BPH, all men aged >/= 50 years of age should be asked about LUTS and informed about disease characteristics and therapeutic options, while sexual function should always be assessed in patients with severe and long-standing LUTS. Initial assessment should include medical history (including drug and co-morbidity history), digital rectal examination, urinalysis, International Prostate Symptom Score-Quality of Life (IPSS-QoL) and a voiding diary, while prostate-specific antigen (PSA) and measurement of prostate volume by suprapubic ultrasonography are indicated in fully informed patients with a life expectancy of >/= 10 years in whom BPH progression could influence treatment choices. QoL considerations should dictate whether to start active treatment. When QoL is not affected by LUTS, watchful waiting is indicated if symptoms are mild, acceptable if they are moderate. When QoL is affected, medical therapy with alpha(1)-blockers or 5alpha-reductase inhibitors (the latter indicated in patients with increased prostate volume) is appropriate. Combined therapy with alpha(1)-blockers + 5alpha-reductase inhibitors should only be considered in patients at high risk for progression (prostate volume > 40 mL or PSA > 4 ng/mL), since the incremental cost of combination therapy vs. monotherapy with alpha(1)-blockers or finasteride is prohibitive."
Advances in the medical management of benign prostatic hyperplasia.
Benign prostatic hyperplasia: when to 'watch and wait,' when and how to treat. (Cleve Clin J Med. 2007) "Many men with BPH are asymptomatic, and many others are not bothered by their symptoms; watchful waiting is appropriate management for these patients. When symptoms affect quality of life, pharmacologic therapy should be an option; choices include an alphablocker, a 5 alpha-reductase inhibitor, or, for men with larger prostates, a combination of the two. Surgical intervention is indicated when BPH leads to other medical complications, including urinary retention and renal insufficiency."
Long-term results of three different minimally invasive therapies for lower urinary tract symptoms due to benign prostatic hyperplasia: Comparison at a single institute. (Int J Urol. 2007)
Epithelializing stent for benign prostatic hyperplasia: a systematic review of the literature. (J Urol. 2007)
Is the minimally invasive treatment as good as transurethral resection for benign prostatic hyperplasia? (Int Urol Nephrol. 2007)
Medical therapy for benign prostatic hyperplasia - present and future impact. (Am J Manag Care. 2007)
Guidelines
Evidence-based guidelines for the management of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary. (Curr Med Res Opin. 2007)
Internet Sites
Treatment Information
Drug-Food-Supplement Information
DrugDigest (drug interactions)
FDA - Drug Interactions: What You Should Know
NIH - Botanical Dietary Supplements: Background Information
NIH - Drug, Supplements, and Herbal Information
NIH - Herbal Supplements: Consider Safety, Too
NIH - Vitamin and Mineral Supplement Fact Sheets
Nutrition
Lycopene Inhibits Disease Progression in Patients with Benign Prostate Hyperplasia. (J Nutr. 2008)
Other
Other Treatments
Microwave thermotherapy for benign prostatic hyperplasia. (Cochrane Database Syst Rev. 2007)
[Evaluation of radiofrequency (TUNA) in the outpatient treatment of benign prostatic hyperplasia] (Prog Urol. 2007)
[Functional outcome after laser vaporisation of the prostate with the KTP laser.] (Urologe A. 2007)
Experimental
Radiotherapy
Supplements-Vitamins-CAM
A comprehensive review on the stinging nettle effect and efficacy profiles. Part II: Urticae radix. (Phytomedicine. 2007)
A prospective study of the efficacy of Serenoa repens, Tamsulosin, and Serenoa repens plus Tamsulosin treatment for patients with benign prostate hyperplasia. (Int Urol Nephrol. 2007) "CONCLUSION: Treatment of BPH by both SR and TAM seems to be effective alone. None of them had superiority to another and additionally, combined therapy (SR + TAM) does not provide extra benefits. Furthermore SR is a well-tolerated agent that can be used alternatively in the treatment of LUTS due to BPH."
Surgery
[Long-term results of lower urinary tract symptoms and urinary flow rate after transurethral resection of the prostate] (Hinyokika Kiyo. 2007)
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