J Korean Med Assoc.  2008 Jul;51(7):672-674. 10.5124/jkma.2008.51.7.672.

Shape-up LUTS/BPH Guideline in Korea: Medical Treatment

• Yoo KH
• Lee SJ

• KMID: 2185918
• DOI: http://doi.org/10.5124/jkma.2008.51.7.672

Abstract

Benign prostate hyperplasia (BPH) is the most common cause of lower urinary tract symptoms (LUTS) in men older than the middle age, and is a pathologic process that contributes to lower urinary tract symptoms in aging men. Despite the significantly different proportion of men with moderate to severe symptoms, a clear trend toward an increase in symptom scores with advancing age is noticeable. Complications of LUTS and BPH, such as urinary tract infections, bladder decompensation, bladder stones, hematuria, urinary incontinence, upper urinary tract deterioration with renal insufficiency, and others are in general rare in properly supervised patients. Medical therapies investigated for BPH include alpha-adrenergic blockers, 5alpha-reductase inhibitors, combination, aromatase inhibitors, and numerous plant extracts. Medical therapy is now the usual first- line management of uncomplicated BPH with either an alpha-adrenergic blocker or (if the prostate is large) a 5alpha-reductase inhibitor. Combination therapy with both an alpha-adrenergic blocker and a 5alpha-reductase inhibitor has been demonstrated to be the most effective means of preventing disease progression.

Keyword

Benign prostate hyperplasia; Complication; Therapy

MeSH Terms

Adrenergic alpha-Antagonists
Aging
Aromatase Inhibitors
Hematuria
Humans
Hyperplasia
Lower Urinary Tract Symptoms
Male
Middle Aged
Plant Extracts
Prostate
Renal Insufficiency
Urinary Bladder
Urinary Bladder Calculi
Urinary Incontinence
Urinary Tract
Urinary Tract Infections
Adrenergic alpha-Antagonists
Aromatase Inhibitors
Plant Extracts

Reference

1. Madersbacher S, Alivizatos G, Nordling J, Sanz CR, Emberton M, de la Rosette JJ. EAU 2004 guideline on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guideline). Eur Urol. 2004. 46:547–554.

2. AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia. Chapter 1: diagnosis and treatment recommendations. J Urol. 2003. 170:530–547.

3. Kirby RS, Roehrborn C, Boyle P, Bartsch G, Jardin A, Cary MM, Sweeney M, Grossman EB. Prospective European Doxazosin and Combination Therapy Study Investigators. Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial. Urology. 2003. 61:119–126.

4. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, Lepor H, McVary KT, Nyberg LM Jr, Clarke HS, Crawford ED, Diokno A, Foley JP, Foster HE, Jacobs SC, Kaplan SA, Kreder KJ, Lieber MM, Lucia MS, Miller GJ, Menon M, Milam DF, Ramsdell JW, Schenkman NS, Slawin KM, Smith JA. Medical Therapy of Prostatic Symptoms (MTOPS) Research Group. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003. 349:2387–2398.

5. Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Morrill B, Montorsi F. CombAT Study Group. The effects of dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the CombAT study. J Urol. 2008. 179:616–621.