Alpha blockers alone are often not sufficient

Various types of medication and drug combinations are available to alleviate prostate problems. Alpha blockers are still the means of choice,"explains Dr. Pedram Derakhshani, urologist at the West German Prostate Center. These drugs lead to relaxation of the smooth muscle cells in the prostate and bladder neck, thus improving the emptying of the bladder. Additional volume reduction can be achieved by the administration of 5-alpha-reductase inhibitors.   A recent study has now shown that in men with an average prostate volume of 55 ml and thus a high risk of progression (advancement of the disease) the only therapy with alpha-blockers is often not sufficient: For example, in every eighth man within four years either the urethra was closed, a so-called urinary retention, or the patient had to undergo surgery to remove the excess prostate tissue. By contrast, a combination therapy with an alpha-blocker (tamsulosin) and a 5-alpha-reductase inhibitor (dutasteride) resulted in a 70 percent reduction of the risk with regard to urinary retention and surgical frequency. The symptoms also showed a clear improvement due to the combined administration of both drugs. If a patient's prostate volume exceeds 40 ml, a combination therapy should be considered,"said Derakhshani.

Gentle laser procedures

However, if the drugs do not lead to the desired success, surgery is usually required to eliminate the urinary flow disorder. Gentle laser procedures such as greenlight laser or diode laser therapy can help here:"In contrast to the classic method of removing the prostate gland, the modern laser procedures are used to gently vaporize excess prostate tissue with little bleeding," explains the urologist from Cologne. Therefore, patients suffering from heart disease, high blood pressure and men with a large prostate benefit from laser procedures.

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