Dr. Haile discusses medical management of BPH

In this video, Eiftu S. Haile, MD, describes the background and findings from the recent Cleveland Clinic Journal of Medicine paper “Medical management of benign prostatic hyperplasia.” Haile is a urology resident at Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio.

Transcription:

Please describe the background for this paper.

Our paper, entitled "Medical management of benign prostatic hyperplasia," focuses on the evolution of the medical treatment for BPH. And we, in this paper, delve into the condition characterized by an increase in glandular epithelial tissue and smooth muscle within the prostate, which can be influenced by a lot of things and a myriad of factors, including hormones and genetics. The main thrust of this work emphasizes that medical management remains the primary approach for symptomatic patients. And then we sort of go into both the traditional and emerging therapies in this space.

Did you notice any trends regarding the use of alpha-blockers and 5-alpha reductase inhibitors for BPH?

We did observe some interesting trends. Alpha-blockers are often, for patients, the first line of treatment because they help quickly relax the smooth muscles in the bladder and the prostate. They ease symptoms by improving urine flow. And so within the paper, we discussed various generations of these drugs, noting that [although] their efficacy is roughly equivalent, their [adverse events], such as dizziness and ejaculatory dysfunction, can vary significantly. On the other hand, 5-alpha reductase inhibitors, or 5-ARIs, are best suited for patients with larger prostates—those greater than 30 cc or 30 grams. These drugs work by reducing the conversion of testosterone, which helps decrease prostate size and improve symptoms over time, though with these medications, the effects may take several months to become apparent.

This transcription was edited for clarity.