Pharmaceutical Chemistry Division, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh - 160 014, India.
Indian J Pharmacol. 2011 Feb;43(1):6-12. doi: 10.4103/0253-7613.75657.
Benign prostatic hyperplasia (BPH) is the most common condition in aging men, associated with lower urinary tract symptoms (LUTS). A better understanding of the prostate physiology, function, and pathogenesis has led to the development of promising agents, useful in the management of LUTS in men. The specific approach used to treat BPH depends upon number of factors like age, prostrate size, weight, prostate-specific antigen level, and severity of the symptoms. 5α-reductase inhibitors decrease the production of dihydrotestosterone within the prostate, which results in decreased prostate volume, increased peak urinary flow rate, improvement of symptoms, decreased risk of acute urinary retention, and need for surgical intervention. α(1)-adrenergic receptor (α(1)-AR) antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Clinical efficacy of either 5α-reductase inhibitor or α(1)-AR antagonist has been further improved by using combination therapy; however, long-term outcomes are still awaited. Many more potential new therapies are under development that may improve the treatment of BPH. This article gives a brief account of rationale and efficacy of different treatment options presently available in the management of BPH.
良性前列腺增生(BPH)是老年男性最常见的疾病,与下尿路症状(LUTS)有关。对前列腺生理学、功能和发病机制的更好理解导致了有前途的药物的开发,这些药物可用于男性 LUTS 的治疗。用于治疗 BPH 的具体方法取决于多种因素,如年龄、前列腺大小、体重、前列腺特异性抗原水平和症状的严重程度。5α-还原酶抑制剂可减少前列腺内二氢睾酮的产生,从而导致前列腺体积减小、最大尿流率增加、症状改善、急性尿潴留风险降低以及手术干预的需求减少。α1-肾上腺素能受体(α1-AR)拮抗剂可减轻有症状的 BPH 男性的 LUTS 并增加尿流率,但不能降低长期尿潴留或手术干预的风险。联合治疗进一步提高了 5α-还原酶抑制剂或 α1-AR 拮抗剂的临床疗效;然而,仍在等待长期结果。许多潜在的新疗法正在开发中,可能会改善 BPH 的治疗效果。本文简要介绍了目前用于 BPH 治疗的不同治疗方案的原理和疗效。