Urolog. pro Praxi, 2008; 9(2): 54-60

Combined therapy of benign prostatic hyperplasia: yes or no?

MUDr. Jiří Klečka Ph.D, doc. MUDr. Milan Hora Ph.D, MUDr. Petr Běhounek

Urologická klinika, FN a LF UK, Plzeň

Medical therapy of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) with either alphalytics nor 5α reductase inhibitors has become the most common treatment choice over the past 15 years, replacing surgical procedures for BPH. Both classes of drugs have demonstrated officiality and safety in numerous placebo controlled, randomized clinical trials. Because of the two different mechanism of action proposed for these two classes of drugs the idea of utilizing both to enhance treatment efficacy appears promising. However, few well conducted trilas are available to adress issue of combination medical therapy of LUTS and BPH, the majority of the data available comming from trials with significant design flaws. Recent evidence suggests superior efficacy of 5α reductase inhibitors in men with large prostate and higher PSA (Prostatic Specific Antigen) level in terms of symptom and outcome prevention. Very promising combination therapy in patient with BPH and over activ bladder (OAB) seems to be using of uroselective alphalytics with anticholinergics. Experimentally starts to use PDE inhibitors in treatment of LUTS based on BPH.

Keywords: benign prostate hyperplasia, lower urinary tract symptoms, alphalytics, inhibitors of 5α reductasis, anticholinergics

Published: May 21, 2008  Show citation