| What is Benign Prostate Hypertrophy?
Benign prostate hypertrophy is a condition of benign enlargement of
prostate mostly found in middle aged men and elder men. There is
abnormal increase in the number of prostatic stromal cells and
epithelial cells leading to the formation of large nodules in the
pre-urethral area of the prostate. Any further increase in their sizes
can block the urethral canal completely or partially, thereby
resulting in the obstruction of urine flow. Several problems can
develop as a result of this, such as:
- Urinary hesitancy
- Frequent urination
- Increased risk of urinary tract infections due to stasis of
bacteria in the bladder residue
- Incomplete voiding
- Post-urination dribble
- Nocturia – Need to urinate during the night
- Dysuria - Painful urination
- Weak urinary stream
- Urinary Retention of acute or chronic nature in which there is
gradual increase in the residual urinary volume, distending the
bladder
- Obstructive uropathy resulting in renal failure
- Urinary bladder stone formation
There is a metabolite of testosterone, known as Dihydrotestosterone
that plays a vital role in the growth of prostate. Dihydrotestosterone
is synthesized under the action of the enzyme 5-alpha-reductase, type
2 in the prostate from the circularizing testosterone. Since this
enzyme is placed mainly in the stromal cells, these cells are the
chief location for the synthesis of dihydrotestosterone. Although all
men demonstrate prostate hypertrophy as they grow old, particularly
after 70 years, the incidence of symptomatic prostatic hypertrophy is
detected more in men leading a western lifestyle than in men from
countryside areas. Benign hypertrophy of prostate is related with
increased levels of serum Prostate Specific Antigen [PSA] which is an
indicator for carcinoma prostate. However, it is not looked at to be a
pre-malignant condition. This condition is diagnosed primarily by
rectal examination and by ultrasonography.
Indications & Dosage
Monotherapy is a symptomatic treatment of benign prostatic
hyperplasia in men having enlarged prostate. It works by improving
symptoms, decreasing the risk of acute retention of urine and lowering
the risk of benign prostatic hyperplasia related surgery.
Avodart along with tamsulosin is indicated for the treatment of
symptomatic BPH in men with an enlarged prostate. As it is mentioned
earlier, Avodart (Dutasteride) treats urinary symptoms of enlarging
prostate, reduces the chances of acute urinary retention and prostate
surgery. As far as dosage is concerned, Avodart can be taken in
capsule form of 0.5mg each on a daily basis for monotherapy. In case
of monotherapy along with alpha blocker, the daily recommended dose is
Avodart 0.5mg once and Tamsulosin 0.4mg once.
Side Effects
Taking Avodart (Dutasteride) can lead to certain side effects, both
in case of monotherapy and in combination with alpha blocker
tamsulosin. Patients on monotherapy usually experience sexual adverse
reactions such as impotence, decreased libido and ejaculatory defects.
Breast disorders like breast enlargement and tenderness have been
reported too.
Similar side effects have been found in combination with alpha
blocker tamsulosin also. Patients can feel dizziness along with
hypersensitivity reactions like uritacaria, rash, pruritis,
angioneurotic edema, etc. However, long term treatment with Avodart up
to 4 years has not witnessed any such side effects.
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