scholarly journals Update on medical therapy for male LUTS

2014 ◽  
Vol 8 (7-8) ◽  
pp. 148 ◽  
Author(s):  
Sidney B. Radomski
Keyword(s):  
Symptom Control ◽  
Prostate Hyperplasia ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Reductase Inhibitors ◽  
Urinary Tract Symptoms ◽  
Phosphodiesterase Type ◽  
Control And Management ◽  
And Storage ◽  
Benign Prostate ◽  
5 Alpha Reductase Inhibitors

The medical management of lower urinary tract symptoms (LUTS) is aimed at addressing voiding and storage symptoms in patients with benign prostate hyperplasia (BPH) symptoms with or without an overactive bladder (OAB). Current available options for BPH include the alpha-blockers, 5-alpha reductase inhibitors, and phosphodiesterase type 5 inhibitors. For OAB, options include antimuscarinics, with or without an alpha-blocker, the beta-3-adrenergic agonist mirabegron, and the synthetic diuretic desmopressin. With the availability of numerous options and combinations available for the treatment of LUTS, individual patient assessment is the key to optimal symptom control and management of adverse effects.

scholarly journals The Effect of Ofloxacin in Men With Elevated Prostate Specific Antigen

2021 ◽  
Author(s):  
Seyedhossein Rabani ◽  
Ali Mousavizadeh ◽  
Seyed Mohammadreza Rabani
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Elevated Serum ◽  
Significant Drop ◽  
Prostate Hyperplasia ◽  
Reductase Inhibitors ◽  
History Of ◽  
Benign Prostate ◽  
5 Alpha Reductase Inhibitors

Abstract Background: Antibiotic prescription is a common practice in men with elevated serum prostate specific antigen. The thought is that if patients were to have a drop in, or normalization of their PSA, we can be able to avoid unnecessary prostate biopsy. The aim of this study was to evaluate the effect of ofloxacin in men with elevated PSA.Methods: 224 men with elevated PSA from the base of 4 ng/ml were enrolled in this study. Exclusion criteria were age less than 50 or greater than 75, history of allergy to fluoroquinolones, cases with history of recent prostate manipulation, men on 5 alpha reductase inhibitors, and known cases of prostate cancer. After a duration of 10 days ofloxacin 200 mg twice a day orally, PSA level was rechecked.Results: Mean age was 61.18 year. Mean PSA level before administering antibiotic was 26.3 ng/ml (-21.9 +97.4). In 120 patients (53.57%) a significant drop in serum PSA was detected so prostate biopsy was not done and in the remainder 104 patients (46.43%), Prostate biopsy was done that showed 65 adenocarcinomas of prostate and 39 benign prostate hyperplasia. Conclusions: This study showed in a patient with active urinalysis (pyuria) and normal rectal examination, trans rectal ultrasonography and prostate biopsy should be post ponded and antibiotic be started. If significant drop in serum PSA was seen, antibiotic should be continued to avoid unnecessary biopsies, otherwise, no benefit in asymptomatic men with normal urinalysis, but elevated PSA.

scholarly journals Sexual Dysfunctions Related to Drugs Used in the Management of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Narrative Review on α-Blockers and 5-Alpha Reductase Inhibitors

Uro ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 82-98
Author(s):  
Antonio La Torre ◽  
Caterina Palleria ◽  
Irene Tamanini ◽  
Andrea Scardigli ◽  
Tommaso Cai ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Sexual Dysfunction ◽  
Lower Urinary Tract ◽  
Prostatic Hyperplasia ◽  
Sexual Dysfunctions ◽  
Reductase Inhibitors ◽  
Urinary Tract Symptoms ◽  
5 Alpha Reductase Inhibitors ◽  
Lower Urinary

This is a critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. In this narrative review, we analyzed data from the literature related to the development of sexual dysfunctions during the treatment of BPH or LUTS. Both α-blockers and 5-alpha reductase inhibitors (5-ARIs) can induce erectile dysfunction, ejaculatory disorders and a reduction in sexual desire. The sexual side effect profile of these drugs is different. Among the α-blockers, silodosin appears to have the highest incidence of ejaculatory disorders. Persistent sexual side effects after the discontinuation of finasteride have been recently reported; however, further studies are needed to clarify the true incidence and the significance of this finding. However, most of the published studies are affected by a weak methodology and other important limitations, with only a few RCTs available. Therefore, it is desirable that future studies will include validated tools to assess and diagnose the sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders.

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