Medical Therapy for BPH

What is Medical Therapy for BPH?

Medical therapy includes the use of drugs to relieve symptoms caused by hyperplasia, as well as the adoption of measures to keep urinary issues under control.

Medication is important in cases where symptoms are extreme and restrictive and impact significantly on patients’ quality of life. When this treatment does not have the effects expected, the alternative is surgery.

In less serious cases, however, patients may be able to manage their symptoms effectively through changes in habits and behaviour

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How is Medical Therapy Administered?

Behavioural measures

There are various measures a patient can take to help relieve issues caused by BPH.

These behavioural strategies and changes in habits consist especially of:

Cutting liquid intake from the afternoon onwards (to reduce trips to the toilet at night) or in situations where access to the toilet may be difficult (e.g. before a show);
Urinating before leaving work (when returning home) and before and during a journey;
Emptying the bladder often (e.g. every 2 or 3 hours) and not trying to hold urine in; urinating when you first feel the desire to do so;
Avoiding long periods without urinating, as it can lead to a full and distended bladder;
Avoiding some types of food (e.g. acidic or spicy foods);
Squeezing the urethra after urinating to help avoid dripping;
Avoiding medication that worsens the symptoms (e.g. nasal decongestants).

These and other measures must be discussed with your urologist to make them as effective as possible and also to learn whether they are good enough to prevent the disease worsening and if they cause complications that can arise if no treatment is given.

Pharmacological measures

In the medical treatment of BPH, three major groups of medication exist:

Alpha blockers (tansulosin, alfuzosin, doxazosin and silodosin, the newest);
5-alpha-reductase inhibitors (finasteride and dutasteride);
Plant extracts – phytotherapy (countless substances have been tested, the most commonly used of which is saw palmetto).

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Your doctor will help you to choose the best treatment for your specific case, suggest measures that substantially improve your quality of life and monitor the response to therapy. The best treatment strategy depends on the severity of your symptoms and the response to the therapy established.

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What is the Follow-Up with Medical Therapy?

Each group of drugs has a specific effect, a particular modus operandi and also specific potential side effects.
Given this, the patient undergoing medical therapy must have regular follow-up consultations to assess the treatment’s efficiency and the symptom-relieving measures.

If necessary, the medication is readjusted or other measures suggested.

The aim is always to help the patient effectively manage their symptoms and significantly improve their quality of life.

Dr. José Santos Dias

Clinical Director of the Instituto da Próstata

Bacherlor's Degree from the Faculty of Medicine at the University of Lisbon
Specialist in Urology
Fellow of the European Board of Urology
Autor dos livros "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" e "Protocolos de Urgência em Urologia"

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