Relevant issues in the therapy of BPH and chronic prostatitis. A lecture

The proficiency in managing benign prostatic hyperplasia (BPH) and chronic inflammation of the prostate is a fairly crucial aspect, considering the drastic changes in the approaches to the treatment. According to the relevant estimates, further ageing of the population is expected. The increase in the number of people over 60 will be over 100% in a number of countries (110% in the USA and 160% in Japan); in some cases, the increase is expected to be up to 200% (Canada). The strategies of management of patients with lower urinary tract symptoms/BPH could be divided into short-term, e.g. quick elimination of the symptoms, and long-term ones, such as monitoring of the symptoms and the quality of life in case of long-term administration of drugs and reducing the probability of side effects. Unfortunately, operative treatment of BPH does not always lead to the spectacular results. according to the results of the studies conducted in our country, 21% of patients are not fully satisfied with the results of treatment; 24% of patients have new urination disorders during the post-operative period; 41% of patients do not have the feeling of a complete recovery after the surgery. The data from many studies indicate the effectiveness and safety of a combined therapy of alpha-blockers (AB) and 5-alpha-reductase inhibitors (5-ARI). This decreases the risk of acute urinary retention by 81%, the risk of BPH progression - by 67% and lowers the probability of surgical intervention by 67% (compared with 68%, 34% and 64% for 5-ARI monotherapy and 35%, 39% and 3% for AB monotherapy, respectively). The advantages of combined administration of drugs are also highlighted in Russian clinical guidelines on urology by YG Alyaev, PV Glybochko and DY Pushkar.