Benign prostatic hyperplasia
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of BPH.
Alternative Names
Enlarged prostate
Highlights
Saw Palmetto
Saw palmetto, a popular herbal remedy for benign prostatic hyperplasia (BPH), does not work any better than placebo, according to an important 2006 study in the
New England Journal of Medicine
. Researchers assigned 225 men with moderate-to-severe BPH to take either placebo or saw palmetto daily for 1 year. Results showed no differences in symptoms between the two groups.
BPH and Kidney Disease
BPH is associated with chronic kidney disease, according to a 2006 study in
Kidney International
. The study found that men who have a bladder obstruction from BPH are three times more likely to develop chronic kidney disease than other men.
Drug Treatment
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An alpha blocker combined with a 5-alpha-reductase inhibitor works better than either drug alone for men with larger prostates, according to a 2006 study in the
Journal of Urology
.
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The alpha blocker alfuzosin (Uroxatral) slows the progression of BPH and improves lower urinary tract symptoms (LUTS) but does not help urinary retention, according to a 2006 study in
BJU International
.
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Although 5-alpha-reductase inhibitors decrease prostate specific antigen (PSA) levels, a PSA test still works well for men who take these drugs. A 2006 study in the
Journal of Urology
found that doctors can accurately calculate PSA levels in men who take dutasteride (Avodart) by doubling the PSA values. The PSA test is a blood test for detecting prostate cancer.
Investigational Drugs
Botulinum toxin A (Botox) may be a helpful new treatment for BPH, according to research presented at the 2006 American Urological Association meeting. Researchers injected Botox into the prostate glands of 41 men with BPH. Eighty percent of patients were able to completely empty their bladder within 1 - 4 weeks after treatment. For some patients, symptom improvement lasted up to 1 year.
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Review Date: 6/26/2006
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Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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