Therapeutic approach in the treatment of benign prostatic hyperplasia
Prostate ( glandulae prostatae ) is a small gland, part of the reproductive system in males, shaped like a chestnut or pyramid little flat front to back. The dimensions of the prostate gland show an age and individual differences. By the age of puberty, the prostate develops slowly and has a small footprint. At puberty it began to grow rapidly to 17 years and reaches its final shape and size with weight around 20 gr.
Benign prostatic hyperplasia or even also called nodular or stromal hyperplasia, is very common abnormality of the prostate. It is present in a significant number of men around 40 years of age, and its incidence increasing with age. Prostatic hyperplasia is characterized by proliferation of the stromal and epithelial elements leading to an increase of the gland and, in some cases, to urinary obstruction. Significant clinical features are associated with Benign prostatic hyperplasia ( BPH ) symptoms in the lower urinary tract (LUTS).
In patients diagnosed with benign prostate hyperplasia, depending on the severity of symptoms, the risk of progression and morbidity determination of the type of therapy : ( monitoring, drug treatment or surgical intervention ) is important next step. In individuals with mild to moderate uncomplicated symptoms of BPH only drug therapy can be applied. The most commonly used are alpha - 1 - blockers and inhibitors of 5 - alpha reductase. Combination of these drugs reduces the symptoms of BPH better and faster than these two drugs individually. Herbal preparations can be used as a supplementary therapy.
Key – words :
alpha – 1 – blockers, 5- alpha reductase, herbal drugs, prostate,
ABRAMS P, CARDOZO L, FALL M i sur. The standardization of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167-78.
Andro MC, Riffaud JP.Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a review of 25 years of published experience.Curr. Ther. Res.1995;56: 796±817.
AUA. Guideline on the management of BHP : 2010update. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/bph managment/chap_1_GuidelineManagementof(BPH).pdf. Accessed June 2011.
Bales G, Christiano AP, Kirsh E, Gerber GS. Phytotherapeuticagents in the treatment of lower urinary tract symptoms: a demographic analysis of awareness and use at the Universityof Chicago.Urology 1999;54: 86±89.
"Basic Principles: Prostate Anatomy". Urology Match. http://www.urologymatch.com.
Web. 14 June 2010.
Charles R. Craig, Robert E. Stitzel . Modern pharmacology with clinical applications, fifth edition : VII. Drugs affecting the endocrine system.
David E. Golan, Armen H. Tashjian, Ehrin J. Armstrong, April W. Armstrong. Principles of pharmacology : the pathophysiologic basis of drug therapy 3rd ed ( Section IV Principles of endocrine pharmacology.
Di Silverio F, Flammia GP, Sciarra A, Caponera M, Mauro M,Buscarini M,et al.Plant extracts in benign prostatic hyperplasia.Minerva Urol. Nefrol.1993;45: 143±9.
EAU Guidelines. Treatment of non-neurogenic male LUTS. http://www.uroweb.org/gls/pdf/12_Male_LUTS.pdf. Accessed June 2011.
Hirano T., Homma M., Oka K. Effects of stinging nettle root extracts and their steroid components on the Na+, K+ -ATPase of the benign prostatic hyperplasia. Planta Med.
Lowe FC, Ku JC. Phytotherapy in treatment of benign prostatic hyperplasia: a critical review.Urology.
McVary, T., K.,MD ( 2004 ). Management of benign prostatic hypertrophy : Prostate Anatomy and Causative Theories, Pathophysiology,and Natural History of BenignProstatic Hyperplasia. © 2004 Humana Press Inc. 999 Riverview Drive, Suite 208Totowa, New Jersey 07512.
Wagner H., Flachsbarth H., and Vogel G. A new antiprostatic principle of sting-ing nettle (Urtica dioica)roots. Phytomedicine.
Wang L, Yang JR, Yang LY, Liu ZT. Chronic inflammation in benign prostatic hyperplasia: implications for therapy. Med Hypotheses 2008;70:1021-3.