RAMB - Fevereiro 2017

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Nunes RV et al.
98 Rev Assoc Med Bras 2017; 63(2):95-99
• • i5ARs are recommended for men with LUTS, enlarged
prostate, and/or high PSA levels. Results begin to be
felt after a few months (4 to 6 months), but can pre-
vent disease progression by reducing the need for sur-
gery and acute urinary retention. (A)
• • i5AR therapy combined with alpha-blockers is recom-
mended for men with moderate to severe LUTS, en-
larged prostate and/or high PSA levels, and reduced
maximum urinary flow. (A)
• • i5ARs therapy combined with alpha-blockers is not rec-
ommended for treatment lasting less than one year. ( A)
• • Muscarinic receptor antagonists and beta-3 agonists
should be considered with caution in men with LUTS
who have predominantly bladder storage symptoms. ( A)
• • Anticholinergic therapy, used alone or in combination
with alpha-1 blocker, increases the risk of acute uri-
nary retention in patients with BPH. (A)
• • iPDE5s are recommended for the treatment of BPH-
-LUTS. This therapeutic class may be an option in the
treatment of patients with erectile dysfunction and
BPH-LUTS. ( A)
• • Addition of iPDE5s to alpha-blockers may improve
BPH-LUTS. ( A)
• • Tadalafil plus finasteride is associated with an im-
provement in erectile function compared to finaste-
ride alone. (A)
• • Patients should be advised of the possible side effects
of BPH drug therapy. ( D)
• • Due to the lack of scientific evidence, there is no rec-
ommendation for the use of herbal medicines in the
treatment of BPH-LUTS. (A)
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