Prostatic hyperplasia, benign, treatment

In order to investigate the mechanisms of adverse events associated with alphai-adrenoceptor antagonists, the Veterans Affairs Cooperative Study database was analysed with respect to the relation between adverse events and hypotension in 1229 men with benign prostate hyperplasia. Treatment with terazosin produced the following rates of adverse events dizziness 19%,... 

Vahlensieck et al. "Benign Prostatic Hyperplasia Treatment with Sabal Fruit Extract." Fortschritte Med 111 ... 

N-Heterocycles as drugs for the treatment of benign prostatic hyperplasia 97JMC1293. 

Ornithine decarboxylase is a pyridoxal dependent enzyme. In its catalytic cycle, it normally converts ornithine (7) to putrisine by decarboxylation. If it starts the process with eflornithine instead, the key imine anion (11) produced by decarboxylation can either alkylate the enzyme directly by displacement of either fluorine atom or it can eject a fluorine atom to produce viny-logue 12 which can alkylate the enzyme by conjugate addidon. In either case, 13 results in which the active site of the enzyme is alkylated and unable to continue processing substrate. The net result is a downturn in the synthesis of cellular polyamine production and a decrease in growth rate. Eflornithine is described as being useful in the treatment of benign prostatic hyperplasia, as an antiprotozoal or an antineoplastic substance [3,4]. 

The expression of TRPVl in the bladder is, however, not restricted to afferent nerves urothelium, detrusor muscle and fibroblasts also express TRPVl in the human bladder [140]. The implication of these findings for intravesical vanilloid therapy is unclear [141], but the increase in TRPVl immunoreactivity in the urothelium in patients with neurogenic detrusor overactivity (that occurs in concert with increased TRPVl in bladder af-ferents) is a very intriguing finding [142]. In the male urogenital system, TRPVl is also present in testicles, prostate and scrotal skin [143], and it was postulated that TRPVl ligands may be beneficial in the treatment of benign prostatic hyperplasia [144]. 

List the desired treatment outcomes for a patient with benign prostatic hyperplasia. 

Compare and contrast a-adrenergic antagonists versus 5a-reductase inhibitors in terms of mechanism of action, treatment outcomes, adverse effects, and interactions when used for management of benign prostatic hyperplasia. 

Formulate appropriate counseling information for patients receiving drug treatment for benign prostatic hyperplasia. 

When monitoring efficacy of drug treatment for benign prostatic hyperplasia, subjective endpoints include relief of obstructive and irritative voiding symptoms. Objective endpoints include improvements of urinary flow rates, decreased post-void residual urinary volume, and decreased complications of disease. 

FIGURE 49-1. Algorithm for selection of treatment of BPH based on symptom severity. (From Lee M. Benign prostatic hyperplasia. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 

Larson TR. Current treatment options for benign prostatic hyperplasia and their impact on sexual function. Urology 2003 61 692-698. 

Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia a randomized international study of 1098 patients. Prostate 4 231-240, 1996. 

Summary of Medical Treatment Options for Benign Prostatic Hyperplasia... 

Before starting testosterone replacement, patients 40 years and older should be screened for benign prostatic hyperplasia and prostate cancer. To ensure an adequate treatment trial, the patient should continue treatment for 2 to 3 months. 

Gillen water, J.Y. et al. 1995. Doxazosin for the treatment of benign prostatic hyperplasia in patients with mild to moderate essential hypertension A double-blind, placebo-controlled, dose-response multicenter study. J Urol. 154 110. 

Figure 12.10. Fluorescence lifetime thermometer used in the treatment of benign prostatic hyperplasia. (From Ref. 51.)...

Abbott Laboratories ( Abbott ) distributes terazosin hydrochloride (known by the brand name Hytrin), which is approved for the treatment of hypertension and symptomatic benign prostatic hyperplasia. The FDA approved the Hytrin tablet NDA on August 7, 1987, and the capsule NDA on December 14, 1994. Abbott sells the dihydrate form of terazosin hydrochloride (having two associated water molecules). ... 

Benign prostatic hyperplasia (BPH) (Prascar on/yj.Treatment of symptomatic BPH in men with an enlarged prostate to improve symptoms, reduce acute urinary retention risk, and reduce the risk of the need for surgery including transurethral resection of the prostate (TURP) and prostatectomy. 

Aside from sildenahl, apomorphine is one of the few orally active (buccal route) pharmacological agents used in the treatment of ED. Apomorphine stimulates penile erection in both normal men and in men who are impotent. Apomorphine can be the drug of choice in patients with coexisting benign prostatic hyperplasia (BPH), coronary artery disease, and hypertension. 

SR009 Giannakopoulos, X., D. Baltogiannis, D. Giannakis, et al. The lipidosterolic extract of Serenoa repens in the treatment of benign prostatic hyperplasia a comparison of two dosage regimens. Adv Ther 2002 19(6) 285-296. 

SR014 Debruyne, F., G. Koch, P. Boyle, et al., and the Groupe d etude PERMAL. Comparison of a phytotherapeutic agent (Permixon) with an alpha-blocker (Tamsulosin) in the treatment of benign prostatic hyperplasia a 1 -year randomized international study. Prog Urol 2002 12(3) 384-392. 

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