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Medical Management of Benign Prostatic Hyperplasia

Therapeutics Initiative (University of British Columbia)

Therapeutics Letter 19 discusses medical management of benign prostatic hypertrophy (BPH). Conclusions: Patients with “mild” symptoms of BPH should be reassured and do not need any treatment. Many patients with “moderate” to “severe” symptoms will improve spontaneously. Alpha-1-antagonists reduce symptoms in some patients. Their effect is detectable within 2 weeks. If the patient experiences no clear benefit by 1 month, the drug should be discontinued. The evidence of a significant benefit to risk ratio for finasteride is less clear. It may be useful for men with large prostates; a therapeutic trial of at least 3 months is required. Saw palmetto extracts cannot be recommended because effective doses of available preparations have not been established and evidence of safety and long term efficacy are insufficient. Before using any drug to treat BPH, develop a clear treatment goal with the patient. The score sheet may be helpful in symptom evaluation. If symptoms are not bothersome and there are no indications for urologic evaluation, try “watchful waiting” first. If this fails, apply the same test to any drug prescribed and evaluate success or failure within the appropriate period of time.

Other

eng

2023-06-20

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/85008

Reviewed

http://creativecommons.org/licenses/by-nc-nd/4.0/