madman
Super Moderator
Figure 2. Classes of medication for the treatment of LUTs and site of action within the lower urinary tract; adapted from Sarma AV,Wei JT. Benign prostatic hyperplasia and lower urinary tract symptoms. N Engl J Med. 2012;367:248-57.
Background
Benign prostatic hyperplasia (BPH) is a condition involving the proliferation of smooth muscle and epithelial cells within the transition zone of the prostate. The process by which this takes place is not precisely known. It does require that testosterone and 5-alpha reductase convert it to dihydrotestosterone (DHT) which is the active androgen within the prostate. The growth of the prostate results from an imbalance between cell growth and cell death. Obstruction occurs via compression of the urethra by the resulting hyperplastic nodules, as well as increased smooth muscle tone and resistance within the enlarged gland. It is an almost universal process in men beginning in their 40’s; it increases to a prevalence of 60% by age 60 and 80% by age 80.1 This results in progressive bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTs). Patients can range from being asymptomatic to severely symptomatic. In the most extreme cases, it can result in complete urinary retention and renal dysfunction. The annual economic impact of BPH has been estimated at nearly $4 billion in the Unites State.
Diagnosis
* History
* Physical Examination
* Laboratory Tests
Treatment
* Watchful Waiting
* Pharmacotherapy
- Alpha Blockers
- 5-alpha Reductase Inhibitors (5-ARIs)
- Phosphodiesterase-5 inhibitors
- Antimuscarinic and Beta-3 Agonist Medication
- Phytotherapy
Surgery
Conclusion
BPH is a common condition affecting millions of men globally. There are a number of treatment options available that can be tailored to an individual’s symptoms and objectives.
Background
Benign prostatic hyperplasia (BPH) is a condition involving the proliferation of smooth muscle and epithelial cells within the transition zone of the prostate. The process by which this takes place is not precisely known. It does require that testosterone and 5-alpha reductase convert it to dihydrotestosterone (DHT) which is the active androgen within the prostate. The growth of the prostate results from an imbalance between cell growth and cell death. Obstruction occurs via compression of the urethra by the resulting hyperplastic nodules, as well as increased smooth muscle tone and resistance within the enlarged gland. It is an almost universal process in men beginning in their 40’s; it increases to a prevalence of 60% by age 60 and 80% by age 80.1 This results in progressive bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTs). Patients can range from being asymptomatic to severely symptomatic. In the most extreme cases, it can result in complete urinary retention and renal dysfunction. The annual economic impact of BPH has been estimated at nearly $4 billion in the Unites State.
Diagnosis
* History
* Physical Examination
* Laboratory Tests
Treatment
* Watchful Waiting
* Pharmacotherapy
- Alpha Blockers
- 5-alpha Reductase Inhibitors (5-ARIs)
- Phosphodiesterase-5 inhibitors
- Antimuscarinic and Beta-3 Agonist Medication
- Phytotherapy
Surgery
Conclusion
BPH is a common condition affecting millions of men globally. There are a number of treatment options available that can be tailored to an individual’s symptoms and objectives.
