5alpha-reductase inhibition for men with enlarged prostate

Abstract

Purpose: Increasingly, men with lower urinary tract symptoms (LUTS) are seeking treatment in the primary care setting. This article reviews the use of alpha-blockers and 5alpha-reductase inhibitors (5ARIs) in the management of LUTS and enlarged prostate.

Data sources: Information is based on a critical review of the published literature. Relevant studies were identified using MEDLINE and review of reference lists of published studies.

Conclusions: Enlargement of the prostate is a common occurrence among aging men. Nurse practitioners (NPs) are in a unique, frontline position to evaluate symptoms and bother and to recommend appropriate treatment of patients with enlarged prostate. Both alpha-blockers and 5ARIs are effective at reducing symptoms in the short term. However, only the 5ARIs impact disease progression and maintain improvement in symptoms in the long term.

Implications for practice: NPs play an important role in assessing and treating LUTS in men with enlarged prostate. When treating men with LUTS, assess the severity of symptoms and the extent of prostate enlargement. For symptomatic men with enlarged prostate, long-term therapy with 5ARIs should be considered to treat symptoms as well as address the disease progression.