Benign Prostatic Hyperplasia (BPH) is a progressive disease that causes lower urinary tract symptoms such as frequent urination, urgency, nocturia, decreased and intermittent force of stream, and the feeling of not emptying the bladder completely.
The disease is defined to manifest as a lower urinary tract dysfunction due to benign hyperplasia of the prostate, and is generally associated with enlargement of the prostate indicative of lower urinary tract obstruction.
Typically, there are no symptoms from an enlarged prostate before the age of 40. About 90% of men have symptoms of BPH by age 85, but only about one-third of men with BPH symptoms are bothered by the symptoms.
Treatment Options on Benign Prostatic Hyperplasia: An Update
Benign prostatic hyperplasia (BPH) causes a sudden impact on overall quality of life of a patient. Here is presented a review of information on medications available for BPH.
The most important treatment option for BPH that has been widely used over the last several decades is the ablative surgical approach. Our knowledge on epidemiology and pathophysiology of the prostate and bladder and the information acquired from endocrinologic and urodynamic investigations in the recent years have allowed us to re-think on the conventional procedures and options to improve both diagnosis and treatment.
Better and minimally invasive surgical therapies, advanced new medical treatments, and medical therapies have provided us more treatment options. New diagnostic, imaging, and robotic and computer-controlled procedures allow visualizing the prostate gland and tracking the prostate gland location during the procedure.
Commonly used treatment and managements options for BPH are:
Watchful waiting: Watchful waiting is a management strategy in which the patient is monitored by the doctor without receiving any medical or surgical intervention for the enlarged prostate (BPH).
Alpha one adrenoreceptor blockers: These blockers reduce smooth muscle tone in the prostate gland and result in rapid improvements in urinary symptoms and flow.
Combination therapies: It has been suggested that combination therapies may reflect the possibility of short-term benefits from the -blockers, such as the relaxation of the smooth muscle to relieve urinary tension, but these might be negated by continued prostate gland growth, which itself can be stopped and reversed by 5 a-reductase inhibition.
Combination therapy with doxazosin and finasteride has been found to provide relief in the symptoms, reduced prostate growth, and reduced need for BPH surgery.
Minimally invasive therapies: Minimally invasive therapies involve heating of the prostate gland by various means (such as electrical, microwave, laser-based heating) to manage enlarged prostate symptoms.
Insertion can be directly into the prostate via a needle or into the urethra via a catheter, probe or endoscope or any other similar device.
Heating can be relatively low energy when the effects are thought to be due to aadrenoceptor blockade or damage and the net effect akin to ablockers.
Phytotherapy: Cernilton, prepared from the rye-grass pollen Secale cereale, is considered a good phytotherapeutic agent and is considered for the treatment of enlarged prostate.
It is used by many men worldwide and is a registered pharmaceutical product throughout Western Europe, Japan, Korea and Argentina. The available evidences indicate that Cernilton is well tolerated and improves overall urological symptoms.