Reviews for Primary Care - Fall 2007 - (Page 1) TREATMENT UPDATE Alpha Blockers for the Treatment of Benign Prostatic Hyperplasia Herbert Lepor, MD Department of Urology, New York University School of Medicine, New York, NY The evolution of alpha blocker therapy for benign prostatic hyperplasia (BPH) has focused on improving convenience and tolerability. Indications for treating BPH include reversing signs and symptoms or preventing progression of the disease. The indication that most commonly drives the need for intervention is relief of lower urinary tract symptoms (LUTS) with the intent of improving quality of life. Alpha blockers are the most effective, least costly, and best tolerated of the drugs for relieving LUTS. Four long-acting alpha 1 blockers are approved by the Food and Drug Administration for treatment of symptomatic LUTS/BPH: terazosin, doxazosin, tamsulosin, and alfuzosin. All are well tolerated and have comparable dose-dependent effectiveness. Tamsulosin and alfuzosin SR do not require dose titration. Alfuzosin, terazosin, and doxazosin have all been shown to be effective in relieving LUTS/BPH independent of prostate size. © 2007 MedReviews, LLC enign prostatic hyperplasia (BPH) describes a proliferative process of both stomal and epithelial elements of the prostate.1 Its prevalence is age dependent.2 Histological evidence of BPH is rarely observed in men under 50 years of age, but by age 80 virtually all men will have some histological evidence of the process. It is unclear what specific factors regulate the degree of hyperplasia, which ultimately dictates the size of the prostate gland, nor is there any consensus regarding the prostate size that qualifies for the diagnosis of benign prostatic enlargement (BPE). B VOL. 1 NO. 1 2007 REVIEWS FOR PRIMARY CARE 1
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