Benign prostatc hyperplasia – medicamentous treatment

Abstract

Benign prostatic hyperplasia (BPH) is characterized with proliferaton of glandular and stromal components of the prostate. BPH can produce prostate enlargement and caused lower urinary tract symptoms (LUTS). The growth of the prostate depends on patent’s age and influence of sexual hormones, specially dihydrotestosterone. Symptoms can be divided as irritatve, obstructve and postmicturation symptoms. The basic evaluation included medical history, symptom score questionnaire, bladder diary, physical examinaton, urinalysis, creatinine and prostate specific antigen serum concentraton, uroflowmetry and postvoid residual urine. The modality of treatment depends about patents symptoms and results of diagnostic evaluaton. The inital step in the treatment are behavioural and dietary modificatons. In the patients with mild symptoms watchful waiting is first line treatment. In the other patients medicamentous treatment is recommended. Pharmacological management included: alpha adrenoreceptor antagonists, 5-alpha-reductase inhibitors, muscarin receptors antagonists, vasopressin analogue – desmopressin, beta-3 agonists, phosphodiesterase 5 inhibitors, phytotherapy and combinaton therapy. If the medicamentous therapy failed or the complicatons of BPH are present surgical treatment is recommended.