ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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Medical Treatment Of Bph: Hormonal Therapy And Aromatase Inhibitors
Dr. Vural SOLOK,a Dr. Oktay DEMİRKESENa
a Üroloji AD, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, İSTANBUL
Although benign prostatic hyperplasia (BPH) has a heterogeneous etiology, it has an androgen depended course with the synergistic role of estrogens.
It is well known that BPH does not occur in men who were castrated before puberty and in genetic disorders, that inhibits androgen production or androgen action. Hormonal therapy is one of the approaches that have an opportunity of reversing or even preventing the hyperplastic state. Therefore they are popular modalities for the medical treatment of BPH.
Many treatment modalities has been tried to inhibit the production or the action of androgen in patients with BPH. Some of these are surgical or medical castration, GnRH analogs, progestational drugs, androgen receptor antagonists, 5α reductase inhibitors, estrogen withdrawal (aromatase inhibitors), and gonadotrophins.
Among these treatment modalities, only 5α reductase inhibitors takes place in BPH Guideline of European Urology Association (EAU). The clinical improvement seen with 5α reductase inhibitor treatment is best validated in men with prostates larger than 40 cc and their effects are best seen after long-term treatment (6 months). These drugs can alter the natural history of symptomatic BPH by influencing acute urinary retention and prostatectomy rates. 5α reductase inhibitors are also effective in macroscopic hematuria related to BPH.Keywords: Prostatic hyperplasia, benign, treatment, medicalTurkiye Klinikleri J Surg Med Sci 2005, 1(1):64-70
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