Benign Prostate Hypertrophy (Hyperplasia) or BPH is an enlargement of the prostate gland which is common in men with increasing age. More than 50% of men over 50 years have an enlarged prostate and may have symptoms of obstruction, such as urinary retention or irritative symptoms such as frequency, urgency, nocturia, urge incontinence resulting from bladder instability. These symptoms can fluctuate and not necessarily deteriorate with time. This kind of prostate enlargement is called benign and distinct from enlargement caused by prostate cancer.
Medication of BPH
Only in severe cases of BPH surgery is indicated, normally medication with so called alpha1-adrenoceptor blockers (alfuzosin, doxazosin, prazosin, tamsulosin or terazosin) produces rapid relief by an action on the smooth muscle of the prostate and the bladder.
The most common side-effect of the therapy is lowered orthostatic blood pressure (f.i. dizziness standing up). This kind of therapy is first choice.
Recently 5 alpha-reductase inhibitors (dutasteride, finasteride) offer an alternative. However therapy with this kind of products takes more time (up to 6 months) and not always gives symptomatic improvement. Finasteride and dutasteride have an anti-androgenic action and consequently a decreased libido and ejaculation disorders may arise. Breast tenderness and enlargement is also frequently reported with finasteride.
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