[Benign prostate hyperplasia: success and limitations of pharmacological therapy].
A profound knowledge of pathogenesis and natural history enables a differentiated therapy for elderly men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH). The role of phytotherapy is still controversially discussed and, therefore, not clearly recommended by any BPH-guideline. alpha(1)-blockers are the therapy of choice for symptomatic patients at a low risk of disease progression (prostate volume <30-40 ml). 5alpha-reductase inhibitors (5ARI) reduce the prostate volume by 20-25% and the risk for acute urinary retention/surgery by more than 50% compared to placebo. Combination therapy (alpha(1)-blocker plus 5ARI) is superior to either monotherapy, though this advantage is only demonstrable after a prolonged treatment period (>12 months).
Madersbacher
S
S
Abteilung für Urologie und Andrologie, Donauspital, Langobardenstrasse 122, 1220, Wien, Austria. stephan.madersbacher@wienkav.at
Marszalek
M
M
D058891:5-alpha Reductase Inhibitors; D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008517:Phytotherapy; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D001748:Urinary Bladder Neck Obstruction / Q000188:drug therapy*; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology; D014563:Urodynamics / Q000187:drug effects
D058891:5-alpha Reductase Inhibitors; D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists