5alpha-reductase inhibition for men with enlarged prostate.
OBJECTIVE
Increasingly, men with lower urinary tract symptoms (LUTS) are seeking treatment in the primary care setting. This article reviews the use of alpha-blockers and 5alpha-reductase inhibitors (5ARIs) in the management of LUTS and enlarged prostate.


METHODS
Information is based on a critical review of the published literature. Relevant studies were identified using MEDLINE and review of reference lists of published studies.


CONCLUSIONS
Enlargement of the prostate is a common occurrence among aging men. Nurse practitioners (NPs) are in a unique, frontline position to evaluate symptoms and bother and to recommend appropriate treatment of patients with enlarged prostate. Both alpha-blockers and 5ARIs are effective at reducing symptoms in the short term. However, only the 5ARIs impact disease progression and maintain improvement in symptoms in the long term.


CONCLUSIONS
NPs play an important role in assessing and treating LUTS in men with enlarged prostate. When treating men with LUTS, assess the severity of symptoms and the extent of prostate enlargement. For symptomatic men with enlarged prostate, long-term therapy with 5ARIs should be considered to treat symptoms as well as address the disease progression.
Issa
Muta M
MM
Department of Urology, Emory University School of Medicine/AVAMC (112), Atlanta, Georgia 30033, USA. issa@emory.edu
Kraft
Kate H
KH
D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000465:Algorithms; D001378:Azasteroids / Q000627:therapeutic use; D003663:Decision Trees; D003937:Diagnosis, Differential; D018450:Disease Progression; D004359:Drug Therapy, Combination; D000068538:Dutasteride; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D018120:Finasteride / Q000627:therapeutic use; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D009730:Nursing Assessment; D010173:Palpation; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014563:Urodynamics
D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists; D001378:Azasteroids; D004791:Enzyme Inhibitors; D018120:Finasteride; D000068538:Dutasteride