Urological Medications

Prescription medications are frequently used to improve urinary symptoms and quality of life, particularly when surgery is not necessary.

For treating BPH, there are two principle classes of medications, 5-alpha-reductase inhibitors and alpha-blockers, and these can be used in combination for maximal effect.

5 alpha-reductase inhibitors

block the conversion of testosterone to dihydrotestosterone, a more active male hormone in the prostate. This class of drug may be used to reduce prostate size with symptom improvement. It is also used to treat male pattern baldness, but can cause side effects including reduction of ejaculate, erectile dysfunction, and sometimes reduced libido. Medications include finasteride and dutasteride.

Alpha-receptor blockers

act by relaxing the muscle of the prostate and bladder neck to improve urine flow. They can occasionally cause side effects that include dizziness, reduction in blood pressure (beneficial if previously elevated), runny nose, headache and sometimes retrograde ejaculation. Medications include tamsulosin, alfuzosin and doxazosin.

Muscarinic receptor blockers

can be used to reduce urinary symptoms due to bladder overactivity. Side effects are variable, including dry mouth and constipation. This class of drug can be contraindicated by glaucoma (an eye condition). A variety of different medications are available, including oxybutinin, tolteridine, trospium, solifenacin, and it may be important that the correct drug is selected depending on other medical conditions.

Phosphodiesterase inhibitors

are used to treat erection problems. These medications strengthen the molecular signals within the penis that initiate and sustain an erection. They include Viagra (Sildenafil), Cialis (Tadalafil) and Levitra (Vardenafil).

Antibiotics

Antibiotics are used to treat or prevent infection. A wide variety are used in urological practice. The more commonly used antibiotics include trimethoprim, nitrofurantoin, cefalexin (and related antibiotics - cephalosporins), augmentin (and related penicillins), ciprofloxacin (and related antibiotics - quinolones).