Inability to Urinate (cont.)
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What Medications Treat Urinary Retention?
There are three types of medications available for treating urinary symptoms in men thought to be related to an enlarged prostate and may be helpful in men with urinary retention secondary to an enlarged prostate (BPH).
The first class of medications (called alpha receptor blockers) work by relaxing the muscles at the neck of the bladder, thus reducing the obstruction to the flow of urine. The common medications in this class are terazosin (Hytrin), tamsulosin (Flomax), doxazosin (Cardura), silodosin (Rapaflo), and alfuzosin (Uroxatral). These medications are generally used for treating long-standing obstructive symptoms due to an enlarged prostate, but they may have a role in treating acute obstruction. Some studies have suggested that early initiation of these medications may improve urinary problems upon the removal of a urinary catheter.
The second class of medications for the treatment of prostate enlargement (called 5-alpha reductase inhibitors) work by shrinking the size of the prostate gland. They inhibit locally (in the prostate) the conversion of testosterone to one of its metabolites which is thought to play a role in increasing prostate size. Finasteride (Proscar) and dutasteride (Avodart) are the two commonly used medications of this type. They are also primarily used to treat long-standing urinary problems due to prostate enlargement. Unlike the other drug class, they play no role in treating acute urinary obstruction because their action of reducing the prostate size may take weeks to months.
The third class of medications for treatment of urinary symptoms related to BPH are PDE-5 inhibitors. Cialis (Sildenafil) is approved for the treatment of BPH symptoms in men. It is not fully known how this medication, which is typically use for troubles with erections, helps with symptoms related to enlargement of the prostate, but studies have shown it as effective as alpha-blockers.
Combination therapy, including an alpha-blocker and a 5-alpha-reductase inhibitor, is useful in men with BPH and appears to be more effective than single drug therapy in preventing progression of symptoms.
Medically Reviewed by a Doctor on 10/27/2016
Pamela I. Ellsworth, MD
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