ISSN: 1305-3876
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Alpha-blockers In The Treatment Of Bph
Dr. Yaşar BEDÜKa
a Üroloji AD, Ankara Üniversitesi Tıp Fakültesi, ANKARA
Studies have shown that,prostatectomy in BPH is not always out of complication. Also some patients with mild symptoms have been operated historicly due to lack of other therepoetic alternatives. Recently,the main goal in BPH treatment is to prevent the conversion of histologic disease to clinical one. Therefore, α-blocker treatment, which decreases the compression in prostatic urethra, has been widely accepted. As it is well known, α-blockers effects the dynamic component of BPH symptoms. Prostatic smooth muscles,bladder neck and urethra are all innervated by sympatetic nevre system. All these areas contain abundant amount of α-receptors. On the other hand, α-receptors are scarse in detrusor muscles,whereas it contains large amount of muscarinic and β-receptors.Studies have revealed that more than %50 patients with prostatic symptoms have detrusor instability. α-blockers,also affecting the α-receptors in bladder, will reduce the irritative symptoms to an extend. α ?blockers have been in usage since 1976. Recently more spesific α-receptors have been discovered in this respect. Today 3 α ?receptors have been described: α1-AR, α2-AR and β-AR. α 1-ABs which are predominated in bladder neck and prostate, have 3 subtypes named; α-1a, α-1b and α-1d. Since prostatic stroma contains mostly the α-1a receptors,the α-blockers specific to this subtype are more uroselective and have only mild side effects. Today alpfuzosine,doxazosine,terazosine and tamsulosine are mostly presicribed drugs worldwide and all have similar effects.Studies have shown that, 60-70% of the patients using this agents, have improvement in their symptoms.Keywords: Alpha-blocker, alpha-receptor, BPH, obstructive symptomsTurkiye Klinikleri J Surg Med Sci 2005, 1(1):54-63
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