Patient's question:
Frequent urination, urgent urination, difficulty urinating, incomplete urination with a single urination. Anal discomfort.Doctor's answer:
Hello:1. Observation and Waiting: Many BPH patients have symptoms that remain mild and stable over a long period, and treatment is not necessarily urgent. Observation and waiting are appropriate. Annual repeat testing should include uroflowmetry, serum PSA, digital rectal examination, B-ultrasound, and the International Prostate Symptom Score.
2. Medication Therapy
(1) Adrenergic α-receptor blockers: These primarily address the tension of smooth muscles in the prostate and bladder neck to reduce urinary resistance. Common medications include:
1. α1 and α2 adrenergic receptor blockers: Phenylephrine is a representative example, taken 10mg once or twice daily. Side effects include orthostatic hypotension and a 30% incidence of dizziness.
2. α1 adrenergic receptor blockers: These can be divided into short-acting and long-acting types.
Short-acting: Prazosin 1mg twice or three times daily; Alfuzosin 2.5mg twice or three times daily.
Long-acting: Tamsulosin (Hypertension) is taken before bedtime each night. Start with 1mg once daily for four days. If no significant dizziness occurs, switch to 2mg once daily.
Among long-acting α1 adrenergic receptor blockers, there is also the α1a-selective blocker Harle (Tamsulosin), which has fewer side effects and better efficacy, taken at 0.2mg once daily.