A review article in the British Journal of Urology reports on the progress being made in the non-surgical treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).
BPH occurs when an imbalance of cell growth and death causes an increase in the prostate volume. This, in turn, leads to obstruction of the bladder outlet, difficulty emptying the bladder, and LUTS. BPH is a progressive disease in which symptoms typically worsen over time and therefore early intervention may be critical to avoid surgery.
Two drugs have been used with some success: 5α-reductase inhibitors (5-ARIs, e.g. finasteride) and α-blockers (e.g. doxazosin). Both drugs modify the cell signaling process that increases prostate volume. Used separately or together, 5-ARIs and α-blockers have the potential to decrease prostate volume and slow the progression of BPH. However, the several previous studies reviewed in this article make it clear that a more thorough understanding of the use of these drugs is necessary. Their efficacy alone and together appears to vary based on the rate of diseases progression and certain patient risk factors. With further research into these factors, it will be possible to make effective non-surgical treatment available to more patients.
This article was co-authored by LUA urologist Mark Emberton, who specialises in benign and malignant disease of the prostate.