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Prostate Problem Guide
The Use Of Medicine In BPH Treatment
There are a number of ways of treating BPH (benign prostatic hyperplasia or an enlarged prostate) of which medical treatments, or the use of drugs, is the commonest form of treatment following watchful waiting.
(Watchful waiting applies in cases where symptoms are mild or where the patient is not particularly troubled by his symptoms and involves simply checking on the patient once or twice a year to ensure that he is not developing complications as a result of his BPH. This can be a useful option for some patients as it avoids the risks associated with other forms of BPH treatment and, on occasions, the symptoms will actually lessen over time.)
One commonly used group of drugs in BPH treatment are alpha-blockers which were originally designed for the treatment of high blood pressure. Alpha-blockers act to relax the muscles of the prostate gland, as well as the neck of the bladder, and so reduce pressure on the urethra and improve the flow of urine.
Although alpha-blockers relieve BPH symptoms they do not reduce the size of the prostate and so the symptoms are likely to return if treatment is stopped. Alpha-blockers will usually produce a moderate reduction in symptoms and common side effects include dizziness, headaches, a stuffy nose and stomach and intestinal problems. These problems appear in about 12% to 15% of patients.
COMPLETE RESPONSE (CR): total disappearance of all evidence of disease using physical examination, laboratory studies and radiologic imaging; a criterion for evaluating the efficacy of a particular anticancer therapy.
IL-1R: interleukin 1 receptor.
PYRILINKS-D® (DpD): a urine test that quantitates bone resorption; the second voided urine specimen is ideal to use; other markers of bone resorption are ICTP and N-telopeptide
URGENCY: the need to urinate very soon.
Another frequently prescribed group of drugs are 5-alpha reductase inhibitors. This particular group of drugs acts to lower the level of the main male hormone found in the prostate gland and thus marginally reduces the size of the enlarged prostate. It is however a very slow acting drug and patients will normally need to take the drug for 6 to 12 months before any effects are evident.
5-alpha reductase inhibitors usually produce less of a reduction in symptoms than alpha blockers but can be particular useful in cases where the prostate is considerably enlarged and patients are at risk of developing acute retention – an inability to urinate. Common side effects resulting from the reduction of the male hormone include erection problems, a decrease in sexual desire and a reduction in the amount of semen produced. These problems are seen in about 5% to 8% of patients.
In cases where the prostate is particularly enlarged and patients are finding that they are especially troubled by their symptoms, the doctor may recommend a combination of both alpha-blockers and 5-alpha reductase inhibitors.
In addition to prescription drugs patients may also wish to consider the use of herbal remedies. A number of such over-the-counter remedies are available but, at present, their effectiveness and safety have not been proved and none are approved for use by the Food and Drug Administration (FDA). In addition, the use of some of the herbal remedies available can lead to distortions in the results of diagnostic tests and also interfere with the actions of prescription drugs. As a result, you should consult your doctor before using any form of herbal remedy.
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