Conservative management of benign prostatic hyperplasia: are urologists satisfied?


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详细

The author presents his point of view on the conservative management of benign prostatic hyperplasia and the role of combination therapy (co-administration of α-blockers and 5α-reductase inhibitors) in the treatment of voiding symptoms. The latest evidence for combination therapy of prostatic hyperplasia published in 2017 is also presented.

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作者简介

A. Govorov

Moscow State University of Medicine and Dentistry

Email: dr.govorov@gmail.com
Dr.Med.Sci., Associate Professor at the Department of Urology Moscow, Russia

参考

  1. Gravas S., Bach T., Drake M., Gacci M., Gratzke C., Herrmann T.R.W., Madersbacher S., Mamoulakis C., Tikkinen K.A.O. EAU Guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), including benign prostatic obstruction (BPO). European Association of Urology, update March 2017. Available at: http://uroweb.org/wp-content/uploads/13-Non-Neurogenic-MaIe-LUTS_2017_web.pdf
  2. Gittelman M., Ramsdell J., Young J., McNicholas T. Dutasteride improves objective and subjective disease measures in men with benign prostatic hyperpIasia and modest or severe prostatic enlargement. J Urol. 2006;176(3):1045-1050.
  3. Roehrborn C., Siami P., Barkin J., Damião R., Major-Walker K., Nandy I., Morrill BB., Gagnier RP., Montorsi F. The effects of combination therapy with dutasteride and tamsuIosin on cIinicaI outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from CombAT study. Eur Urol. 2010;57:123-131.
  4. Roehrborn C., Oyarzabal P., Roos E., Calomfirescu N., Brotherton B., Wang F., Palacios JM., Vasylyev A., Manyak MJ. Efficacy and safety of a fixed-dose combination of dutasteride and tamsulosin treatment (Duodart) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment-naïve men with moderately symptomatic benign prostatic hyperplasia: 2-year CONDUCT study results. BJU Int. 2015; 116(3):450-459.
  5. Spivak L.G., Lokshin KL, Vinarov AZ. Rewiev of clinical studies on combination therapy of 5a-reductase inhibitors and a1-blockers in patients with benign hyperplasia. Urologiia. 2015;(4):125-133. Russian (Спивак Л.Г., Локшин К.Л., Винаров А.З. Обзор клинических исследований комбинированной терапии ингибиторами 5α-редуктазы и α1-адреноблокаторами пациентов с гиперплазией предстательной железы. Урология. 2015;4:125-133).
  6. Roehrborn C., Oyarzabal P., Roos E., Calomfirescu N., Brotherton B., Palacios J.M., Vasylyev A., Manyak M.J. Can we use baseline characteristics to assess which men with moderateIy symptomatic benign prostatic hyperplasia at risk of progression will benefit from treatment? A post hoc analysis of data from the 2-year CONDUCT study. World J Urol 2017 Mar;35(3):421-427.
  7. Yamanishi T., Asakura H., Seki N., Tokunaga S. Efficacy and safety of combination therapy with tamsulosin, dutasteride and imidafenacin for the management of overactive bladder symptoms associated with benign prostatic hyperplasia: а multicenter, randomized, open-label, controlled trial (DIrecT Study). Int J Urol. 2017 May 2. doi: 10.1111/iju.13359. [Epub ahead of print].
  8. Matsumoto T., Hatakeyama S., Yoshikawa K. A randomized, open-label, multicenter study evaluating efficacy of switch from dutasteride to tadalafil in benign prostatic hyperplasia patient with lower urinary tract symptoms (D-to-T trial). Eur Urol. Suppl 2017;16(3);e928.
  9. Branche B., Howard L., Moreira D., Castro-Santamaria R., Andriole G., Hopp M., Freedland S. Sleeping problems are associated with increased risk of BPH progression: results from REDUCE. J Urol. 2017. 197;4S(Supplement):e102.
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