Other Treatments for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: Self-management, Desmopressin and Phytotherapy

Abstract

A substantial number of men with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) who undergo watchful waiting or medical therapy still have bothersome symptoms. Other therapies, like self-management, the use of desmopressin and phytotherapy, may serve as adjuvant treatments for men with LUTSI BPH. Self-management refers to education and training of patients to learn the day-to-day management and control of their own symptoms. Recommendations for employing self-management for LUTS/BPH include: education and reassurance, lifestyle modification and behavioral changes. Nocturia, defined as the complaint that an individual wakes one or more times at night to pass urine, is one of the most bothersome symptoms for men with LUTS/BPH. Although the cause of nocturia is multi-factorial, some men with LUTS/BPH may receive benefit from the use of desmopressin. Clinical effects of desmopressin in decreasing nocturia have been confirmed by several drug trials but its use requires caution. Side effects like lower leg edema, headache and dizziness are not unusual from the use of desmopressin, and significant hyponatremia is present in about 5% of cases. Phytotherapy refers to using herbal supplements to treat ailments. Currently, a few herbalagents have been used either solely or conjointly to treat LUTSI BPH. Among the herbal agents, saw palmetto has been most frequently used for treating LUTS/BPH. In general, saw palmetto IS well tolerated and patient compliance is usually good. However, its therapeutic effects on LUTS/BPH are not consistent among clinical trials.