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Medikamentöse BPS-Therapie

Eine systematische Übersicht

Drug therapy for benign prostatic hyperplasia

Systematic overview

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Zusammenfassung

5α-Reduktasehemmer und α1-Rezeptorenblocker sind etablierte Optionen zur symptomatischen Therapie des benignen Prostatahyperplasiesyndroms (BPS). Maximale Wirkeffekte sind an korrekte Dosierungen gebunden und erfordern eine sorgfältige Patientenselektionen hinsichtlich der verwendeten Substanzklasse. Alle einsetzbaren Präparate wirken nur geringgradig auf eine prostatabedingte Obstruktion. Diese sollte daher durch geeignete urologische Untersuchungen vor Therapiebeginn ausgeschlossen werden. Bei geringem Leidensdruck kann auf eine medikamentöse Therapie verzichtet werden. Symptomatische Patienten mit kleinem Prostatavolumen sind Domäne der Monotherapie mit α1-Rezeptorenblockern, symptomatische Patienten mit großem Prostatavolumen profitieren von einer Kombinationstherapie. Unabhängig vom Einsatz von 5-alpha-Reduktasehemmern bei BPS-Patienten sollte auf die Möglichkeit der BPS- und PCA-Prävention basierend auf Resultaten der NIH-Studie MTOPS („medical therapy of prostatic symptoms“ und der SWOG-Studie PCPT „prostate-cancer prevention trials“ hingewiesen werden.

Abstract

5α-Reductase inhibitors and α1-receptor blockers are established options for symptomatic treatment of benign prostatic hyperplasia (BPH). Achieving maximum efficacy is contingent on correct dosage and requires careful patient selection in view of the substance class employed. All applicable preparations exert only a low-grade effect on prostatic obstruction. This condition should be excluded by appropriate urological examination before treatment is initiated. If the patient’s distress is minor, refraining from drug therapy can be considered. Symptomatic patients with small prostate volume are suited for monotherapy with α1-receptor blockers and symptomatic patients with large prostate volume profit from combination therapy. When 5α-reductase inhibitors are used, BPH patients should be made aware of the findings from the Prostate Cancer Prevention Trial.

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Authors and Affiliations

  1. Urologie, PAN-Klinik, Köln

    R. Berges

  2. Oberhausen

    K. Höfner

  3. Urologie, PAN-Klinik, Zeppelinstraße 1, 50667, Köln

    R. Berges

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  1. R. Berges
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  2. K. Höfner
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Correspondence to R. Berges.

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Berges, R., Höfner, K. Medikamentöse BPS-Therapie. Urologe [A] 44, 505–512 (2005). https://doi.org/10.1007/s00120-005-0798-4

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  • DOI: https://doi.org/10.1007/s00120-005-0798-4

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