Benign prostatic hyperplasia lower urinary tract symptoms

Chappie CR. Pharmacological therapy of benign prostatic hyperplasia/ lower urinary tract symptoms an overview for the practicing clinician. BJU Int 2004 94 738-744. 

O The lower urinary tract symptoms and signs of benign prostatic hyperplasia are due to static, dynamic, or detrusor factors. The static factor refers to anatomic obstruction of the bladder neck caused by an enlarged prostate gland. The dynamic factor refers to excessive stimulation of a-adrenergic receptors in the smooth muscle of the prostate, urethra, and bladder neck. The detrusor factor refers to irritability of hypertrophied detrusor muscle as a result of long-standing bladder outlet obstruction. 

Surgical intervention should be reserved for patients with severe lower urinary tract symptoms of benign prostatic hyperplasia or those with complications of disease (such as recurrent urinary tract infections, renal failure, and bladder calculi). 

Djavan B, Chappie C, Milani S, Marberger M. State of the art on the efficacy and tolerability of alpha, adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Urology 2004 64 1081-1088. 

Milani S, Djavan B. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia latest update on a, adrenoceptor antagonists. BJU Int 2005 95(Suppl 4) 29—36. 

Kuzmin, and R. R. Amdiy. Early urodynamic effects of the lipido-ste-rolic extract of Serenoa repens (Permixon ) in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 2000 3(3) 195-199. 

Lowe FC. Roie of the newer alpha,-adrenergic-receptor antagonists in the treatment of benign prostatic hyperplasia-related lower urinary tract symptoms. Clin Ther... 

Roehrborn CG, Schwinn DA Alphai-adrenergic receptors and their inhibitors in lower urinary tract symptoms and benign prostatic hyperplasia. J Urol 2004 171 1029. [PMID 14767264]... 

Inaba M, Otani Y, Nishimura K, Takaha N, Okuyama A, Koga M, Azuma J, Kawase I, Kasayama S. Combination therapy with rofecoxib and finasteride in the treatment of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia. Metab Clin Exp 2005 54 55-9. 

Zlotta AR, Teillac P, Raynaud JP, Schulman CC. Evaluation of male sexual function in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) treated with a phytotherapeutic agent (Permixon ), tamsulosin or finasteride. Eur Urol 2005 48 269-76. 

Gerber GS, Fitzpatrick JM. The role of a lipido-sterolic extract of Serenoa repens in the management of lower urinary tract symptoms associated with benign prostatic hyperplasia. BJU lnt. 2004 94 338-344. 

Symptomatic benign prostatic hyperplasia (BPH) is a common medical problem in older men. As many as 40% of men aged 60 years or older have lower urinary tract symptoms consistent with bladder outlet obstruction. Treatment goals in the vast majority of men are to relieve bothersome symptoms that reduce quality of life. In the U.S., treatment for benign prostatic hyperplasia costs more than 2 billion per year and accounts for 1.7 million physician office visits annually (Ishani et al., 2000). 

Sanchez-Chapado M, Guil M, Alfaro V, Badiella L, Fernandez-Hernando N. Safety and efficacy of sustained-release alfuzosin on lower urinary tract symptoms snggestive of benign prostatic hyperplasia in 3,095 Spanish patients evaluated during general practice. Eur Urol 2000 37(4) 421-7. 

S. repens (American dwarf palm tree, cabbage palm, sabal, saw palmetto) has mainly been used to treat benign prostatic hyperplasia. In placebo-controlled and comparative studies its efficacy in benign prostatic hyperplasia and lower urinary tract symptoms has been demonstrated (5). Numerous mechanisms of action have been proposed, including an antiandrogenic action, an anti-inflammatory effect, and an antiproliferative influence through inhibition of growth factors. 

Roehrborn CG. Efficacy and safety of once daily alfuzosin in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia A randomized, placebo-controlled trial. Urology 2001 58 953—959. 

Sexual function In a post hoc analysis of a Japanese trial, ejaculatory dysfunction was associated with larger symptomatic improvements in lower urinary tract symptoms with silodosin [95. The authors suggested that the pharmacological receptor target for improvement in the symptoms of benign prostatic hyperplasia may be the same target as that for ejaculatory dysfunction. 

Sexual function There was a clear association between a-adrenoceptor antagonists and ejaculatory dysfunction (pain/discom-fort) in an observational study in Spanish men with benign prostatic hyperplasia and/or lower urinary tract symptoms [106 ]. The presence and severity of symptoms were assessed using the male sexual health questionnaire there was an 83% prevalence of ejaculatory dysfunction in patients taking a-adrenoceptor antagonists. Most cases of ejaculatory dysfunction were mild and severe dysfunction occurred in only 4% of cases. Although the adverse effects on sexual function were seen with all of the a-adrenoceptor antagonists, alfuzosin was associated with better ejaculatory function than tamsulosin, terazosin, or doxazosin. 

Prostatic enlargement is the main disease of the lower urinary tract where drugs can be used to postpone, or avoid, surgery.The symptoms of benign prostatic hyperplasia are partially relieved either by r/ -adrenoceptor blockade or by inhibiting synthesis of dihydrotestosterone in the prostate. 

Alfuzosin selectively blocks alpha-adrenergic receptors in the lower urinary tract, which cause smooth muscle in the bladder neck and prostate to relax, resulting in improved urine flow and a reduction in symptoms of benign prostatic hyperplasia (BPH). It is used in the treatment of BPH. Alfuzosin is a quinazoUne-based a, receptor antagonist with similar affinity at all of the a, receptor subtypes. Its bioavail-abUity is about 64% it has a half-life of 3 to 5 hours. The recommended dosage is one 10-mg extended-release tablet daily to be taken after the same meal each day. 

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