Tags

Type your tag names separated by a space and hit enter

Managing the progression of lower urinary tract symptoms/benign prostatic hyperplasia: therapeutic options for the man at risk.
BJU Int. 2007 Aug; 100(2):249-53.BI

Abstract

There are two fairly divergent reviews in this month's issue. The first is a paper which concentrates on the progression of LUTS and BPH. Previous papers on LUTS and BPH were focused on changes in urinary flow rates and symptom scores, a rather static view of things. The first author in this review introduced the concept of dynamic variables in LUTS and BPH, and this, along with the idea of progression of the disease which the MTOPS study brought to our notice, has lead to a major change to our approach to trials of therapy in LUTS and BPH. The second review is really statement of a theory, an expression of a concept being proposed by the author, which hopefully will be of interest to the reader. In benign prostatic hyperplasia (BPH), increased prostate volume has been shown to be associated with future symptom deterioration and progression to acute urinary retention (AUR) or BPH-related surgery. Dihydrotestosterone (DHT) is the primary androgen responsible for prostate growth. Inhibition by 5alpha-reductase inhibitors (5-ARIs) of the enzyme responsible for the production of DHT decreases prostate volume. This translates to an overall improvement in symptoms and a reduction in the risk of AUR and/or BPH-related surgery. Selective blockage of alpha(1)-adrenoceptors, principally in the region of the prostate, results in rapid symptom relief for the patient but this does not translate into a long-term reduction in the risk of AUR or BPH-related surgery. Given their different modes of action the rationale has always existed for using 5ARIs and alpha-blockers together in men deemed to be both symptomatic and at risk of progression. The factors that predict this progression and the methods available to reduce the risk of it occurring are the subjects of this review.

Authors+Show Affiliations

Department of Urology, University College London, London, UK. memberton@dial.pipex.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

17617135

Citation

Emberton, Mark, et al. "Managing the Progression of Lower Urinary Tract Symptoms/benign Prostatic Hyperplasia: Therapeutic Options for the Man at Risk." BJU International, vol. 100, no. 2, 2007, pp. 249-53.
Emberton M, Zinner N, Michel MC, et al. Managing the progression of lower urinary tract symptoms/benign prostatic hyperplasia: therapeutic options for the man at risk. BJU Int. 2007;100(2):249-53.
Emberton, M., Zinner, N., Michel, M. C., Gittelman, M., Chung, M. K., & Madersbacher, S. (2007). Managing the progression of lower urinary tract symptoms/benign prostatic hyperplasia: therapeutic options for the man at risk. BJU International, 100(2), 249-53.
Emberton M, et al. Managing the Progression of Lower Urinary Tract Symptoms/benign Prostatic Hyperplasia: Therapeutic Options for the Man at Risk. BJU Int. 2007;100(2):249-53. PubMed PMID: 17617135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Managing the progression of lower urinary tract symptoms/benign prostatic hyperplasia: therapeutic options for the man at risk. AU - Emberton,Mark, AU - Zinner,Norman, AU - Michel,Martin C, AU - Gittelman,Marc, AU - Chung,Moon-Kee, AU - Madersbacher,Stephan, PY - 2007/7/10/pubmed PY - 2007/9/21/medline PY - 2007/7/10/entrez SP - 249 EP - 53 JF - BJU international JO - BJU Int. VL - 100 IS - 2 N2 - There are two fairly divergent reviews in this month's issue. The first is a paper which concentrates on the progression of LUTS and BPH. Previous papers on LUTS and BPH were focused on changes in urinary flow rates and symptom scores, a rather static view of things. The first author in this review introduced the concept of dynamic variables in LUTS and BPH, and this, along with the idea of progression of the disease which the MTOPS study brought to our notice, has lead to a major change to our approach to trials of therapy in LUTS and BPH. The second review is really statement of a theory, an expression of a concept being proposed by the author, which hopefully will be of interest to the reader. In benign prostatic hyperplasia (BPH), increased prostate volume has been shown to be associated with future symptom deterioration and progression to acute urinary retention (AUR) or BPH-related surgery. Dihydrotestosterone (DHT) is the primary androgen responsible for prostate growth. Inhibition by 5alpha-reductase inhibitors (5-ARIs) of the enzyme responsible for the production of DHT decreases prostate volume. This translates to an overall improvement in symptoms and a reduction in the risk of AUR and/or BPH-related surgery. Selective blockage of alpha(1)-adrenoceptors, principally in the region of the prostate, results in rapid symptom relief for the patient but this does not translate into a long-term reduction in the risk of AUR or BPH-related surgery. Given their different modes of action the rationale has always existed for using 5ARIs and alpha-blockers together in men deemed to be both symptomatic and at risk of progression. The factors that predict this progression and the methods available to reduce the risk of it occurring are the subjects of this review. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/17617135/Managing_the_progression_of_lower_urinary_tract_symptoms/benign_prostatic_hyperplasia:_therapeutic_options_for_the_man_at_risk_ L2 - https://doi.org/10.1111/j.1464-410X.2007.07056.x DB - PRIME DP - Unbound Medicine ER -