Medical treatment of Benign Prostatic Hyperplasia

The medical therapy for benign prostatic hyperplasia has a short history, which started no farther back than 25-30 years ago. Before then, surgery was the only real treatment for prostatic disease aimed at also resolving the associated lower urinary tract symptoms (LUTS).
Nowadays, several drugs are available for the treatment of prostatic enlargement, which stop or minimize glandular growth, improve bladder neck and urethral hypertonicity or reduce the associated LUTS. They can be used as a monotherapy or in various combinations.
This book is meant to be a summary of the latest developments in the management of benign prostatic hyperplasia and a guide to the use of drugs, focusing on their biological mechanisms of action and their adverse events. The Authors involved in this work are the back-bone of research in this field in Italy. Therefore this is an indispensable reference book useful to fellows and specialists in urology.
Contents
ETIOPATHOGENETIC AND PATHOPHYSIOLOGIC PATHWAYS
Ethiopathogenesis
Pathophysiology of benign prostatic obstruction
Bladder and prostatic urethra innervation
CLINICAL ENDPOINTS OF MEDICAL TREATMENT, INDICATIONS AND PATIENT SELECTION
Indications and patient selection
Clinical endpoints
MEDICAL TREATMENT
α1-blockers
α1-blockers
Androgen manipulation: 5-α-reductase inhibitors, other antiandrogens, aromatase inhibitors (antiestrogens)
5-α-reductase inhibitors
Other androgen manipulations
Treatment of symptoms related to BPH: anticholinergics (antimuscarinics), phosphodiesterase-5 inhibitors, β3-agonists
Muscarinic receptor antagonists
Phosphodiesterase type 5 inhibitors
Combination therapy in BPH
Therapy with α-adrenergic blockers
Androgen manipulation
Combination therapy with α blocker and 5-α-reductase inhibitor
Anticholinergic (antimuscarinic) receptor blockers
Phosphodiesterase inhibitors
Phytotherapy and nutraceuticals
Pygeum africanum
Hypoxis hemerocallidea
Cucurbita pepo
Epilobium spp.
Lycopersicum esculentum
Pinus pinaster
Roystonea regia
Secale cereale
Urtica dioica
Serenoa repens
Conclusions