Korean J Androl.
2004 Dec;22(3):93-100.
Benign Prostatic Hyperplasia and Alpha Adrenoceptor Blockers
- Affiliations
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- 1Department of Urology, Chonbuk National University Medical School, Jeonju, Korea. rain@moak.chonbuk.ac.kr
Abstract
- Benign prostatic hyperplasia (BPH) is the most common disease affecting middle-aged and elderly men. The symptoms of BPH are brought on by enlargement of the prostate by epithelial and smooth muscle cells, urinary obstruction, increased outflow resistance, and unstable detrusor muscle response to obstruction. There are three alpha-1 adrenoceptor (AR) subtypes in prostatic stromal tissue: alpha-1A AR, alpha-1B AR, and alpha-1D AR. Alpha-1 AR blockers relax the prostatic smooth muscle and bladder neck leading to pressure decreases in the bladder and urethra. This treatment improves urinary flow, because 98% of alpha-1 AR is located in the prostatic stroma, and alpha-1 AR is increased in smooth muscle of the enlarged prostate. A selective alpha-1A AR blocker improves obstructive symptoms than irritative symptoms because of the characteristics and distribution of alpha-1A AR and alpha-1D AR in the genito-urinary tract. A combined therapy with selective alpha-1A and alpha-1D AR blockers may improve both voiding and filling symptoms.
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