[Contemporary medical management of the benign prostatic syndrome].

Der Urologe. Ausg. A
S MadersbacherK Dreikorn

Abstract

Two groups of drugs, alpha blockers and 5-alpha-reductase inhibitors (5ARI), are currently widely used for the medical treatment of benign prostatic syndrome (BPS). Alpha blockers are characterized by a rapid onset of efficacy. If given at an adequate dose, all alpha blockers have a similar efficacy, yet quantitative differences regarding side effects exist. The onset of clinical efficacy of 5ARIs is delayed and dependent on prostate volume. Symptom improvement is generally less pronounced than with alpha blockers, yet this difference declines with time. 5ARI, in contrast to alpha blockers, reduce prostate volume and the risk of long-term BPS complications such as prostate surgery or acute urinary retention. The combination therapy of alpha blockers and 5ARI is superior to either monotherapy; however, this superiority becomes evident only after prolonged (>1 year) therapy. Because of additive side effects, this combination should be reserved for BPS patients with a high risk of progression. Regarding plant extracts, no definitive recommendation can be given because of a limited number of high-quality clinical trials. The use of antimuscarinics in men with BPS with a dominance of storage symptoms and without significant obstruct...Continue Reading

References

May 5, 2000·The Cochrane Database of Systematic Reviews·T WiltJ Lau
May 5, 2000·The Cochrane Database of Systematic Reviews·T WiltJ Lau
Jul 26, 2002·The Cochrane Database of Systematic Reviews·T WiltR Mac Donald
Dec 19, 2003·The New England Journal of Medicine·John D McConnellUNKNOWN Medical Therapy of Prostatic Symptoms (MTOPS) Research Group
Sep 15, 2004·European Urology·Frans DebruyneUNKNOWN ARIA3001, ARIA3002 and ARIB3003 Study Investigators
Feb 24, 2005·Der Urologe. Ausg. A·S MadersbacherK Dreikorn
May 19, 2005·Journal of Cataract and Refractive Surgery·David F Chang, John R Campbell
Feb 10, 2006·The New England Journal of Medicine·Stephen BentAndrew L Avins
Nov 16, 2006·JAMA : the Journal of the American Medical Association·Steven A KaplanZhonghong Guan
Nov 16, 2006·Der Urologe. Ausg. A·M C MichelK Höfner
Apr 10, 2007·European Urology·Stephan MadersbacherGeorg Schatzl

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