✨ Benign Prostatic Hyperplasia (BPH) is a condition that can affect quality of life, but there are treatment options to help manage symptoms. ⁠
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✨ BPH is a non-cancerous enlargement of the prostate, often affecting men as they age. It’s driven by increased dihydrotestosterone (DHT) in the prostate, which promotes cellular growth and hyperplasia. This can block urine flow, causing lower urinary tract symptoms (LUTS) such as urgency, frequency, nocturia, and incomplete emptying.⁠
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✨ There are many drugs that can worsen BPH. Check out the post for a fun mnemonic to help you learn the drugs.⁠
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✨ Alpha-1 adrenergic antagonists relax bladder smooth muscle to reduce obstruction. Uroselective agents like tamsulosin, alfuzosin, and silodosin target alpha-1A receptors in the prostate, minimizing side effects like dizziness and orthostasis. However, they can increase the risk of Intraoperative Floppy Iris Syndrome during cataract surgery. Silodosin may cause sexual side effects, while alfuzosin can cause QT prolongation.⁠
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✨ 5 alpha-reductase inhibitors shrink the prostate by inhibiting the conversion of testosterone to DHT. Finasteride targets type II alpha-reductase, while dutasteride inhibits both types. Dutasteride may require 6 months or more for maximum effect.⁠
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✨ PDE-5 inhibitors promote smooth muscle relaxation in the prostate and bladder. BPH and erectile dysfunction (ED) often occur together. Caution is needed when using tadalafil with alpha-blockers due to the risk of hypotension, and is also contraindicated in patients taking nitrates.⁠
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✨ By targeting the mechanisms driving prostate growth and urinary symptoms, we can help “clear the way” for better patient outcomes and “ease the flow” of their quality of life.⁠