Taking Pills for BPH – Easy, But Not Always Best

Let’s face it; as a consumer, it’s easy to take a pill. You may already be taking other pills and this is just one more to add to the rotation. As a urologist, prescribing BPH medication is simple as well. It doesn’t take a lot of time and there is no cost to the clinic. In fact, most of the time, the patient will be satisfied at the initial follow-up visit.  A satisfied patient doesn’t complain.  A satisfied patient needs no additional intervention.

Not so fast.

We all know the easy way isn’t always the best way. It’s easier to sit on the couch than to get a workout in; easier to eat fast food than prepare a nutritious meal at home. The consequences of taking the easy way may not appear on day one (what’s the harm in skipping one workout?), but over time these consequences can add up. This is very true in BPH treatment too. Unfortunately, the consequences of choosing the easy way are starting to show up all too often.

What’s the easy way?  Alpha blockers; a medication that dominates all other drug classes for the treatment of BPH.  They are the easy way because they are very effective at moderately relieving some of the voiding symptoms of BPH for many men.1 However, they do not address the cause of the problem – prostatic obstruction. What are some of the potential consequences of addressing the symptoms but not the cause?  Chronic prostatic obstruction can lead to changes in the bladder as a function of overcoming the obstruction. This may include: bladder muscle (detrusor) thickening and decompensation, elevated PVRs (Post-Void Residual Volume), bladder stones and more.

Of course, the only way to know your best course of action with regard to the symptoms of BPH is to speak to your urologist. Weigh your options and make the decision you and your physician believe to the best course of treatment for your circumstance.

1Roehrborn CG, et al. The Effects of Combination Therapy with Dutasteride and Tamsulosin on Clinical Outcomes in Men with Symptomatic Benign Prostatic Hyperplasia: 4-year Results from the CombAT Study.  Eur Urol. 2010 Jan;57(1):123-31