Combination Therapy for the Pharmacological Management of Benign Prostatic Hyperplasia
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The management of symptomatic benign prostatic hyperplasia (BPH) continues to evolve, with new techniques and forms of medical management being introduced and traditional surgical techniques being used less frequently. Medical management of BPH has evolved from nonspecific α-adrenoceptor antagonists to uroselective α-adrenoceptor antagonists and 5-α reductase inhibitors. Traditionally, α-adrenoceptor antagonists have been used for relief of lower urinary tract symptoms (LUTS) as a result of BPH and are known for their quick onset of action. 5-α Reductase inhibitors have proven useful for the prevention of BPH progression as measured by prostate volume, disease progression, incidence of acute urinary retention and the need for subsequent BPH-related surgery. Recent studies have shown that the combination of an α-adrenoceptor antagonist and a 5-α reductase inhibitor has significantly better efficacy than either drug alone or placebo. Currently, α-adrenoceptor antagonists are used in the acute setting or for short-term relief of LUTS. The combination of an α-adrenoceptor antagonist and a 5-α reductase inhibitor is used for the longer term management of BPH symptoms and to prevent progression of BPH and perhaps avoid surgical intervention.