Available Drugs for Treating LUTS

Background

As men age, many of them are frequently known to have some voiding symptoms due to some age-related functional and anatomical changes in the prostate; these voiding symptoms are collectively called LUTS - short for lower urinary tract symptoms.

Before modern drugs are available over the past 6-7 decades, men with trouble urination usually just wait and see beside at times possibly taking some folklore herbal supplements until urinary retention, the end of trouble voiding, happens to them.

Modern Drugs for LUTS

Nowadays, pharmaceutical industries made a big stride to make a number of modern prostate-related drugs available for very effectively treating men's prostate-related voiding trouble.

There are five groups of drugs to help improve lower urinary tract symptoms--LUTS.

Group 1 is one of alpha-blockers to help relax the urinary sphincter (bladder neck and prostate urethra) like alfuzosin (Uroxatrol), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax), or terazosin (Hytrin); If effective, one may see urine flow improvement within 1-3 days after taking such drugs.

Group 2 is 5ARIs--5-alpha reductase inhibitors to help shrink the prostate like finasteride (Proscar) or dutasteride (Avodart).

Group 3 is MRAs--muscarinic receptor antogonist to help suppress the over-activity of bladder muscle (detrusor).

Group 4 is PDE-5 inhibitors primarily for erectile dysfunction, but somehow proved to help improve LUTS. Among sildenafil, vardenafil, and tadalafil, Tadalafil (Cialis) is the only one documented PDE-5 inhibitor to work for erectile dysfunction (ED) as well as for BPH /

LUTS. But its high cost oftentimes may prohibit its regular use; instead, the combined daily use with one of alpha-blockers and on-demand use of one of PDE-5 inhibitors is preferred.

Group 5 is combination of group 1--alpha-blocker and group 2--5ARI. At times, the drugs in group 1 and 2 may be selected and used together to maximize the effect to improve urine flow and ease voiding symptoms; example - dutasteride + tamsulosin (Jalyn) . If working, urine flow may be improved within 1-3 days and optimized in 1-3 months after their combined use.

Outcome and Recommendation

If you tolerate these drugs well to help improve urination, make sure to take them indefinitely.

Despite taking drugs, the voiding symptoms of LUTS may expectedly and slowly worsen because the drugs only help modify how bladder and urethra work and would not stop the continual accumulation of undesirable ill effects of aging.

To be safe, the patients with above LUTS and on medication will be still strongly advised to be followed closely by urologist for reviewing symptoms and checking post-void residual urine (PVR) about twice yearly. Nonetheless, please follow the advices from your doctors.