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Conditions: BPH

Treating BPH

Among medical therapies used to treat BPH, alpha-adrenergic blockers tend to be used most. There are 4 alpha blocker drugs used to treat BPH: Cardura, Flomax, Hytrin, and Uroxatral.

Alpha blocker therapy is based on the idea that the LUTS associated with BPH are caused partly by obstruction resulting from the contraction of smooth muscle cells in the prostate. The alpha blockers inhibit the process by which this contraction occurs and, thereby, relieve the obstruction. According to the 2006 update of the AUA Guideline on the Management of Benign Prostatic Hyperplasia, clinical studies show these drugs to be similarly effective in reducing LUTS, improving patients’ BPH Symptom Score Index by 4 to 6 points on average.

The other drugs used to treat BPH are the 5 alpha-reductase inhibitors. Two are available: Avodart and Proscar. These drugs work by bringing about hormonal changes that actually shrink the prostate.

The AUA guideline recommends that these drugs be used only by men with clear signs of prostate enlargement, not simply LUTS. According to the AUA guideline, in men with substantially enlarged prostates, these drugs can increase urinary flow rate and lower both the risk of acute urinary retention and the need for BPH-related surgery. In such men, they also can reduce LUTS, producing on average a three-point improvement in the BPH Symptom Score Index. They are, however, less effective in relieving LUTS than alpha blockers and ineffective against LUTS in patients without enlarged prostates.

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