Cancer: BPH

BPH is a non-cancerous enlargement of the prostate gland that commonly occurs in older men. It can cause bothersome urinary symptoms such as difficulty starting urination, weak urine stream, frequent urination (especially at night), and the feeling of incomplete bladder emptying. Alpha blockers work by relaxing the smooth muscle in the prostate and bladder neck, which can improve urine flow and relieve BPH symptoms.

information on the frontline therapy for treating enlarged prostates or benign prostatic hyperplasia (BPH) using alpha blocker medications. Alpha blockers are indeed commonly prescribed by primary care physicians, emergency doctors, and urologists to manage BPH symptoms effectively.

Medications like alpha blockers don't actually treat BPH, they treat the symptoms by relaxing the muscle around the urethra, so thereby reducing some of the resistance.

Sometimes we will add in a second line medication in order to try and shrink the prostate. These medications are called the five alpha reductase inhibitors. So we have Proscar or Avodart These are medications which work by lowering the conversion of testosterone within the prostate. Over a period of 6 to 12 months, this can shrink the prostate by around 20%.

Taking five alpha reductase inhibitors may be a good option for patients looking to avoid surgical therapy. The downside is that it is again a lifelong therapy and it can have sexual impacts by lowering the libido. Some people have also experienced some breast tenderness and less ejaculatory volume with these medications.

Studies have shown that when an alpha blocker and a five alpha reductase inhibitor are used together, patients had the best improvements in their IPSS scores and had the greatest reduction in risk of having acute retention or needing surgery, four years after initiating dual therapy. At this point, if you are not happy with medication therapy, then the next step would be surgical therapy. This would be a maximal tissue removing surgery where it’s minimally invasive and office based.

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