Drug treatment for benign prostatic hyperplasia

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7089.1215 (Published 26 April 1997) Cite this as: BMJ 1997;314:1215

Decreasing muscle tone within the prostate gland may be more effective than reducing the size of the prostate

  1. Andrew Farmer, General practitioner and research fellowa,
  2. Jeremy Noble, Consultant surgeonb
  1. a Health Services Research Unit, Department of Public Health and Primary Care, University of Oxford, Oxford OX2 6HE
  2. b Department of Urology, Oxford Radcliffe Hospital, Oxford OX3 7LT

    Benign prostatic hyperplasia is a common condition in men.1 Patients may present with filling symptoms (frequency, urgency, and urge incontinence) or voiding symptoms (hesitancy, poor urinary stream, straining, intermittent stream, and a feeling of incomplete bladder emptying), or both.2 The aim of treatment is primarily to relieve symptoms. Until the early 1980s the only treatment options were surgery (usually with transurethral resection) or simply waiting to see whether natural resolution of symptoms occurred.3 After the identification of adrenoceptors in the smooth muscle of the prostate gland in the 1970s, urologists began to consider the possibility of using selective α1 adrenoceptor antagonists (α blockers) to relieve symptoms.3 An alternative drug treatment became available in 1992 with the introduction of finasteride, a 5α reductase inhibitor. Until recently, the relative effectiveness of these two types of drugs was uncertain, but further information has now become available.4

    Symptoms of benign prostatic hypertrophy can begin as early as the third decade of life. They increase with age, until about a fifth of …

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