Established medical therapy for benign prostatic hyperplasia.
Benign prostatic hyperplasia is characterized by smooth muscle and epithelial proliferation primarily within the prostatic transition zone that can cause a variety of problems for a patient, the most frequent being bothersome lower urinary tract symptoms. In most cases, medical therapy has become the first-line treatment modality of choice, with a variety of pharmacologic mechanisms proving to be beneficial. Several large trials have shown the efficacy of alpha-receptor blocking and 5-alpha reductase inhibiting medications when used alone and in combination. Newer data has shown the benefit of anti-muscarinic medications in specific populations who suffer from bladder outlet obstruction causing storage urinary symptoms. Phytotherapeutic supplements are numerous and used frequently; however, data supporting safety and efficacy is limited, making treatment recommendations difficult. The available clinical trial data for all of these types of therapy is discussed in this article.
Auffenberg
Gregory B
GB
Department of Urology, Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Tarry 16-703, Chicago, IL 60611-3008, USA.
Helfand
Brian T
BT
McVary
Kevin T
KT
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D008517:Phytotherapy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D053448:Prostatism / Q000188:drug therapy
D000317:Adrenergic alpha-Antagonists; D018680:Cholinergic Antagonists; D004791:Enzyme Inhibitors; D018727:Muscarinic Antagonists