There are multiple treatment options for BPH
There are many ways to manage BPH, ranging from conservative treatment or supplements to surgical removal of the prostate. Depending on the severity of the symptoms and any complications resulting from the bladder outlet obstruction, certain options may or may not be appropriate.
Conservative treatment options for BPH
If the symptoms are not very bothersome, it may be effective to make lifestyle adjustments to reduce urinary symptoms, such as weight loss, fluid restriction in the evening, and avoidance of caffeine. Avoiding some over-the-counter medicines like antihistamines and decongestants, which can slow the urinary stream, is also helpful. Eventually, a large portion of patients will suffer from the progression of prostate enlargement.
There are a few types of medications that treat BPH.
- Alpha-blockers: These medicines act on a receptor of the smooth muscle cells in the urethra and prostate, causing them to relax and improving the flow of urine out of the bladder. Common alpha-blockers are tamsulosin or alfuzosin. These medications can cause dizziness, headaches, fatigue and other side effects.
- 5-alpha reductase inhibitors: These medicines stop the conversion of testosterone to dihydrotestosterone (DHT), which will shrink the prostate. This type of medication takes weeks to months to work. Examples of 5-alpha reductase inhibitors are dutasteride and finasteride. While these medications do work to reduce prostate size and prostate-specific antigen (PSA), they can also have unwanted side effects. These include decreased sex drive, erectile dysfunction, gynecomastia and decreased ejaculate volume.
- Phosphodiesterase inhibitors: These medications also relax smooth muscle in the urethra to a lesser extent than the alpha-blockers. The most used medication in this class is tadalafil. They are also used to treat erectile dysfunction, which makes them a great option if someone suffers from both conditions.
- Anticholinergics: This class of medications does not directly treat the prostate gland, but it does address the bladder dysfunction that BPH indirectly causes. These medications work by relaxing the bladder muscle called the detrusor and are commonly prescribed for patients with overactive bladder. They are appropriate to use in patients who have BPH but are not struggling with significant urinary retention. Because anticholinergic medications have systemic effects, they often cause side effects such as dry mouth, blurry vision, and rapid heart rate.
- Combination therapy: Often, taking two or more classes of these medications is employed. There are studies showing certain combinations can be more effective than single therapy alone, particularly in men with large prostates.
If you have been diagnosed with Benign Prostate Hyperplasia, BPH? You have multiple treatment options for your BPH. If a PAE is an option you are considering, contact Summit Interventional Radiology to schedule an appointment today.