Medical therapy options for aging men with benign prostatic hyperplasia: focus on alfuzosin 10 mg once daily

Abstract

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are common in aging men and can signifi cantly affect quality of life. Men with bothersome LUTS/BPH often present with various other age-related conditions, including sexual dysfunction, heart disease, hypertension, diabetes, and the metabolic syndrome, which can complicate management decisions. Therefore, healthcare providers should be familiar with fi rst-line treatment options for LUTS/BPH and their differing safety profi les, particularly with respect to cardiovascular and sexual function side effects. This article presents a review of fi rst-line medical therapy options for managing aging men with LUTS/BPH and patient considerations when evaluating and selecting these therapies, with a focus on the clinical effi cacy and cardiovascular and sexual function safety profi les of the uroselective α 1 -adrenergic receptor antagonist alfuzosin 10 mg once daily. Alfuzosin improves LUTS, peak urinary fl ow rates, and disease-specifi c quality of life, reduces the long-term risk of overall BPH progression, and is well tolerated in aging men, with minimal vasodilatory and sexual function side effects, even in those with comorbidities. Alfuzosin is well tolerated when used in combination with antihypertensive medications and phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction. The long-term clinical effi cacy and good cardiovascular and sexual function safety profi le of alfuzosin can contribute to an improved quality of life for aging men with LUTS/BPH.

Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up

“…Medical therapy is usually the first-line treatment option and is indicated for patients with moderate lower urinary symptoms (patients with IPSS between 8 and 19) [4][5][6]. Medical therapies for BPH relief include alpha-blockers and 5-alpha-reductase inhibitors (5-ARI).…”

“…Medical therapies for BPH relief include alpha-blockers and 5-alpha-reductase inhibitors (5-ARI). Medical therapy is indicated for patients with moderate lower urinary symptoms with no absolute surgical indications [6,7].…”

Metabolic syndrome does not impair the response to alfuzosin treatment in men with lower urinary tract symptoms: a double-blind, randomized, placebo-controlled study

“…We measured serum HbA1c levels of ≥8% in patients with MetS; however, we randomized the patients with similar IPSS scores into groups to prevent a potential bias of selection. On the contrary, Roehrborn et al [26] found a close association of MetS components with LUTS in older men, whereas Joseph et al [30] detected that hypertension or diabetes mellitus were at a risk of moderate-to-severe LUTS. However, in a recent survey, a significant positive association was not found between MetS or IR and LUTS in men or women.…”

“…By inhibiting smooth muscle α-adrenergic receptors, the drugs relax prostatic and bladder neck smooth muscles and partially improve LUTS by relieving bladder outlet obstruction. [26] Although α-blockers have a proven role for the symptomatic treatment of LUTS, there is little evidence about their efficacy for the treatment of LUTS in men with MetS. Gökkaya et al [27] prospectively evaluated the effects of IR on the outcomes of doxazosin treatment for LUTS in 64 patients.…”

Beneficial Effect of a Multifunctional Polyphytocompound in Experimental Prostatic Hyperplasia in Rats

“…It has been reported that about 90% of men between 45 and 80 years old complain of some degree of LUTS (3 mcWary). More precisely, it seems that by the age of 50 [3,4] 50% of men may show the symptoms related with BPH and in those aged above 70 years this condition is the most significant cause of bladder outflow obstruction. From the histological viewpoint, the process which starts from the transitional or periurethral zone determines hyperplasia of glandular and stromal tissue with papillary buds and increased smooth muscle, lymphocytes and ducts [5,6].…”