An enlarged prostate, known as benign prostatic hyperplasia (BPH) mainly affects men over 50. While the situation is not considered life-threatening, it can reason problems with urination. Medications are available to treat range BPH, when required, which can decrease inflammation and even reverse enlargement in many cases.
Knowing the Right Time to Start
While it may seem reasonable to treat on diagnosis, evidence largely suggests that may not be required. According to the National Institutes of Diabetes, Digestive, and Kidney Disorders (NIDDKD), as many as one in three men with BHP will see their symptoms resolve without any treatment whatsoever. As such is, most specialists will encourage you to take a wait-and-see approach and not rush into treatment.
There are several types of drugs with different mechanisms of action that can be used to treat or minimize symptoms of BPH:
Alpha-blockers work by relaxing the muscles of the prostate and bladder neck. While alpha-blockers are effective in around 75 percent of cases, they typically provide only modest relief and, as such, are generally reserved for men with milder symptoms.
5-Alpha Reductase Enzyme Inhibitors
5-alpha reductase enzyme inhibitors work by shrinking the prostate gland and are most effective in men whose prostate are significantly enlarged. While it may take time for the drugs to take full effect (from three to six months on average), they can often help men avoid the require for surgery.
Two different 5-alpha reductase inhibitors have been approved by the FDA:
- Proscar or Propecia (finasteride)
- Avodart (dutasteride)
The best candidates for combination therapy are men with an enlarged prostate and high PSA levels. An alpha-blocker combined with a 5-alpha-reductase inhibitor provides benefit by relaxing the prostate gland while gradually reducing its size.
A large-scale study conducted in 2006 showed that combination therapy resulted in a 66 percent reduction in symptoms of BPH compared to 34 percent with an alpha-blocker and 39 percent with a 5-alpha-reductase inhibitor alone.
Heat therapy (hyperthermia) is an outpatient treatment that is sometimes used to avoid surgery. The process involves the insertion of a thin, flexible device into the urethra to deliver heat directly to the prostate gland. It can employ microwave, laser, or electro-vaporization technology and has been shown to be 74.9 percent effective in shrinking an enlarged gland.
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