Surgical treatment

After the analysis obtained during the initial examination of data, exclusion of prostate cancer and BPH diagnosis before the doctor gets the choice of tactics: surgery, drug therapy or follow-up.

On the basis of modern ideas to be assigned to medical therapy of BPH patients with initial manifestations of disorders of urination without engaging in the process of the upper urinary tract complications in patients with relative and absolute contraindications to surgical treatment, patients who refused surgical treatment, or by postponing it for various current views on masturbation reasons.

Dynamic observation is acceptable in patients with mild symptoms of BPH (IPSS J 8), and patients, quality of life are not significantly affected because of existing symptoms. Surveillance of such patients includes an cialis brand explanation of the need to control the way of life, regular delivery of blood and urine tests, monitoring PSA, ultrasound, and uroflowmetry.

Surgical treatment is indicated in patients with symptomatic, involving in the process of the upper urinary tract who have contraindications to medical therapy or have reason to believe that medication will be ineffective.

If questions of viagra pfizer cialis eli lilly  levitra bayer surgical treatment of BPH does not cause in recent years a lively debate and transurethral resection of benefit over other techniques is a well-established fact, the issue of medical treatment of BPH such clarity is not observed.

Below are the main groups of drugs used for medical therapy of BPH, depending on their origin and the point of application in the pathophysiology of urination disorders in BPH:

We believe that the first category of patients who have symptoms of bladder outlet obstruction takes precedence over the order brand viagra tablet actual increase in prostate size, shows a-blocker therapy. This choice is due to proven ability to drugs in this group significantly increased Qmax and lower score of IPSS, without reducing the volume of the prostate that is not necessary in this patient.

Proved that in the body of the bladder revealed predominantly cholinergic and b-adrenergic nerve endings, while the posterior urethra and prostate gland contain mainly aadrenergicheskie receptors. This distribution of receptors plays an important role in the coordination of muscles of the bladder and prostate.

Studies in recent years have shown that BPH leads to increased activity of sympathetic nerve fibers, which causes an increase in the tone of smooth muscle structures, the base of the bladder, posterior urethral and prostate. The process of hyperplasia is how to satisfy woman predominantly due to stromal component of the prostate gland, which contains up to 60% of smooth muscle fibers that are point of application a-blockers. The mechanism of action of a-blocker is a relaxation of smooth muscles of the bladder neck and posterior urethra due to the blockade a1adrenoretseptorov. This is the most popular and largest group of drugs. A comparative analysis of treatment of different a-blockers proved their effectiveness against symptoms of urinary identical [5,7].

In Russia the most popular drugs in this group is alfuzosin. He was taken twice a day to 5 mg after a meal. Currently, there is a new dosage form of sustained-release preparations containing 10 mg of alfuzosin and figured on single dose during the day. Very popular and other members of this pharmacological group doxazosin and terazosin. Both drugs are designed for single dose during the day, the dose is titrated. I terazosin standard dose ranges between 5 and 10 mg, whereas doxazosin is better to use 4-8 mg. Tamsulosin once assigned to 0.4 mg.