Endocrine therapies for BPH: scientific rationale, clinical results, and XXXX selection.

@entity1 @entity10831 @entity137 @entity342
In 1993, medical therapy for BPH is a reality. @entity342 deprivation therapy (LHRH agonists, antiandrogens, and @entity10831 inhibitors) has been shown to be effective by reducing the static component of BPH. Of these agents, the @entity10831 inhibitors have the greatest promise because of their low @entity137 profile. Aromatase inhibitors, which function via a different mechanism, however, have not been demonstrated, as monotherapy, to be effective in the treatment of symptomatic BPH. It is still theoretically possible that aromatase inhibitors could have a role in the management of prostatism if they are utilized in conjunction with an antiandrogen or @entity10831 inhibitor. Although the early results for this endocrine therapies are encouraging, several issues relating to medical treatment remain unanswered. Not everyone with significant prostatism will respond to @entity342 deprivation therapy. How does the physician identify pre-treatment the @entity1 most likely to achieve a significant improvement in voiding function with @entity10831 inhibitor therapy? At the present time, there is no method--based on symptoms, DRE findings, serum hormone and PSA levels, or histopathologic criteria--for recognizing the ideal @entity1 for @entity342 deprivation therapy. Without question, it is a subjective decision. As a result, the benefits and risks of these medical approaches as well as those of the minimally invasive and surgical therapies must be discussed with the @entity1 so that he can participate in the management decision. In this manner, the expectations and needs of the @entity1 will be best served.
