Medical treatment of urinary retention due to enlarged prostate

This article describes about the treatment for Urinary retention which occurs in men due to enlargement of Prostate gland. Read to know more about the Alpha blockers and the alpha reductase inhibitors and combination therapies useful for treatment of urinary retention because of enlarged prostate in men.

Benign enlargement of prostate is a non malignant enlargement of prostate and commonly presents with a problem of hesitency, frequency or retention of urine. Detail presentation is given at Causes and features of enlarged prostate. There are several modes to diagnose enlarged prostate and to differetiate it from prostate cancer. The details to know about the investigations to rule out prostate cancer is given at Diagnosis of enlarged prostate.

Regarding treatment, now a days there are several medical treatment available for enlarged prostate. Though the definitive treatment is still the surgical one which may be operative or non operative requiring minimal invasion.

Medical treatment of enlarged prostate

There are several drugs available for treatment of enlarged prostate if there is mild to moderate symptoms. Initial step is to detect any urinary infection and if present proper antibiotic therapy is given. For enlarged prostate following medication is effective.

Alpha blockers for enlarged prostate

Alpha blockers used as an anti hypertensive causes a relaxation of the bladder neck thus voidation of urine is easier, it is used in moderate retention. Most commonly used alpha blocker is tamsulosin branded as urimax. Other alpha blockers used are terazosin branded as hyatrin, doxazosin branded as Cardura and alfuzosin branded as Uroxatral.

As enlargement of prostate is commonly seen in elderly commonly after 50, many patients might be using viagra or sildenafil or tadafil. In such patient alpha blocker may be dangerous as there is interaction between sildenafil and alpha blockers and drastic reduction in blood pressure may take place. It is wise to reveal to the doctor if any one is on viagra.

5 alpha reductase inhibitors for enlarged prostate

5 alpha reductase inhibitors are enzymes which helps in reducing the size of prostate. Two drugs of this category is generally used that is finasteride branded as Proscar and dutasteride branded as Avodart. The initiation of action is longer and so is the duration of action. Finasteride and dutasteride also lowers protein specific antigen level from blood which is measured to interpret the existence of prostate cancer, thus a cancer can be subdued so it is necessary to diagnose enlarged prostate and rule out existence of prostate cancer before starting this drug.

Combination therapy

As alpha blockers are quicker in action and 5 alpha reductase are late for have longer duration of action, most urologist prefer a combination therapy with both alpha blocker and 5 alpha reductase inhibitors.

The combination therapy with medicines is ideal for mild to moderate enlargement where urinary retention is not frequent. It may delay in causing urinary retention and surgery can be avoided for longer duration.

In severe cases surgical treatment is initiated which may be non operative like transurethral needle ablation or microwave therapy or may be operative like transurethral resection of prostate.


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