Oelke M, Kuczyk M A, Herrmann T R W
Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
Urologe A. 2009 Nov;48(11):1365-75; quiz 1376-7. doi: 10.1007/s00120-009-2141-y.
The majority of men with benign prostatic hyperplasia (BPH) seek medical help because of lower urinary tract symptoms (LUTS). Pharmacological treatment of BPH is indicated if the patient has no absolute indications for prostate surgery or benign prostatic obstruction (BPO), but LUTS with a decrease of quality of life. Plant extracts can be prescribed in men with mild to moderate symptoms. alpha-Blockers can quickly and effectively decrease LUTS and symptomatic disease progression. If patients have predominantly bladder filling symptoms and a small prostate, muscarinic receptor antagonists are a viable treatment option. The combination of an alpha-blocker plus a muscarinic receptor antagonist is more effective than single drugs used alone. Especially in men with larger prostates, 5alpha-reductase inhibitors can decrease LUTS and the probability of acute urinary retention as well as need for prostate surgery. The combination of alpha-blocker plus 5alpha-reductase inhibitor can reduce LUTS and disease progression more effectively than single drugs.
大多数良性前列腺增生（BPH）男性因下尿路症状（LUTS）寻求医疗帮助。如果患者没有前列腺手术或良性前列腺梗阻（BPO）的绝对指征，但LUTS导致生活质量下降，则可采用药物治疗BPH。轻度至中度症状的男性可开具植物提取物。α受体阻滞剂可快速有效减轻LUTS及症状性疾病进展。如果患者主要表现为膀胱充盈症状且前列腺较小，毒蕈碱受体拮抗剂是一种可行的治疗选择。α受体阻滞剂加毒蕈碱受体拮抗剂的联合用药比单独使用单一药物更有效。特别是前列腺较大的男性，5α还原酶抑制剂可减轻LUTS、降低急性尿潴留的可能性以及前列腺手术需求。α受体阻滞剂加5α还原酶抑制剂的联合用药比单一药物更能有效减轻LUTS和疾病进展。
