Risks And Side Effects In The Medical Management Of Benign Prostatic Hyperplasia

December 2023 in “ Prostate International ”

Abdulghafour Halawani, Ryan F. Paterson, Tianshuang Zhong, Katie Du, Runhan Ren, Connor M. Forbes

TLDR Medications for BPH can have significant side effects, so understanding these risks is important for treatment decisions.

The document reviews the risks and side effects of medical treatments for benign prostatic hyperplasia (BPH), focusing on alpha-blockers, phosphodiesterase-5 inhibitors (PDE5-Is), and 5-alpha-reductase inhibitors (5ARIs). Alpha-blockers can cause dizziness, hypotension, and ejaculatory dysfunction. PDE5-Is may lead to back pain, headache, and hypotension, especially when combined with alpha-blockers. 5ARIs can cause sexual side effects, gynecomastia, psychiatric issues, and are linked to metabolic syndrome and increased diabetes risk, with studies involving over 55,000 men. Cardiovascular risks and the controversial use of 5ARIs in prostate cancer prevention are noted. Treatments for urgency and nocturia have side effects like dry mouth and hypertension. Phytotherapies like saw palmetto show limited evidence. The review stresses discussing these risks with patients and considering minimally invasive surgical alternatives.

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