Treatment of Lower Urinary Tract Symptoms in Aging Men
DOI: 10.3238/zfa.2015.0345-0351german translation / full article
Background: Lower urinary tract symptoms (LUTS) are a common problem in aging men. This overview of the current treatment methods focus on a critically appraised and evidence-based pharmacotherapy.
Methods: A pragmatic search has been done primarily for newer, preferably evidence-based review articles and guidelines in independent critical drug bulletins, core medical journals and publications of urology societies and other institutions. In particular, certain specific and controversial points were verified in original articles in Medline.
Results: The various classes of drugs used to treat LUTS in men – alpha adrenergic blocking drugs, 5-alpha reductase inhibitors, anticholinergics, beta adrenergic agonists and phosophodiesterase-5 inhibitors – are discussed. In addition consideration is given to non-pharmacological measures and surgical treatment options.
Conclusions: With good education and appropriate non-drug measures it is often possible to cover a long period without medication. For more marked symptoms, alpha blockers have established themselves as a first-line therapy. With 5-alpha reductase inhibitors prostate size can be reduced without surgical treatment. If surgery becomes necessary – after several years of drug therapy or because of a complication such as acute urinary retention – transurethral prostate resection is no longer the only option. Today various minimally invasive techniques may have a lower risk of complications.