Patient's question:
Frequency of urination, urgency of urination, difficulty urinating, incomplete urination in one go. Discomfort in the anus.Doctor's answer:
Hello:1. Observation and Waiting: Many BPH patients have symptoms that remain mild and stable over a long period, making immediate treatment unnecessary. Observation and waiting are recommended, with annual repeat tests including 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. Dual 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 categorized into short-acting and long-acting types.
Short-acting: Prazosin 1mg twice or three times daily; Afuzosin 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, then switch to 2mg once daily if no significant dizziness occurs.
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.