4.3.1 Sintesi e raccomandazioni - Biblioteca Medica

Alfuzosin, Doxazosin, Tamsulosin and Terazosin are appropriate drugs for the
treatment of LUTS/BPH associated with worsening of quality of life
Finasteride and Dutasteride are appropriate drugs for the treatment of LUTS/
BPH associated with a worsening of quality of life in patients with documented
increase in prostate volume
Finasteride and Dutasteride are appropriate drugs for the treatment of LUTS/
BPH that do not worsen quality of life in patients with marked increase in prostate
volume and who are at risk of acute urinary retention
With the so far available data, it is doubtful that Phytotherapeutic agents and
Mepartricin are appropriate drugs for the treatment of LUTS/BPH
The use of antiandrogens and of LH-RH analogues is not recommended for
patients with LUTS/BPH.
Combined therapy (α1-adrenergic blocker + 5-α-reductase inhibitor) is a
therapeutic option to be taken into consideration for the treatment of patients with
LUTS/BPH at high risk of progression (prostate >40ml or PSA >4ng/ml)
A
A
B
C
E
B
Surgery
Open prostatectomy, Transurethral resection of the
prostate (TURP), Transurethral incision of the
prostate (TUIP)
TUVAP
Holmium laser prostate resection
I
I
III
Both open prostatectomy and TURP achieve significant and persistent subjective
(symptom questionnaires) and objective (Qmax, postvoid residue urine)
improvement, with an acceptable risk of short- and long-term complications
TUIP achieves significant subjective (symptom questionnaires) and objective
(Qmax, postvoid residue urine) improvement in patients with a prostate of 20-
30ml. The complication rate is lower than with TURP and open prostatectomy,
but the re-intervention rate is slightly higher
Both open prostatectomy and TURP achieve significant improvement in quality
of life in most patients presenting with moderate to severe symptoms
48