Growing older has its perks -- heftier income, respect of one's peers -- and its drawbacks such as, for men, a steady enlargement of the prostate gland.
Soon, men with this problem may have a broader set of therapeutic options.
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Botox for the prostate?
For The Record
Los Angeles Times Wednesday, May 14, 2008 Home Edition Main News Part A Page 2 National Desk 2 inches; 77 words Type of Material: Correction
Enlarged prostate: An article in Monday's Health section about treatments for prostate enlargement gave inaccurate descriptions of two drugs used to treat the condition. The article said the drug dutasteride (Avodart) is an alpha blocker, used to relax muscles in the prostate and bladder. It also said tamsulosin (Flomax) is in a class of drugs called 5-alpha-reductase inhibitors, used to help shrink the prostate. In fact, Flomax is an alpha blocker, and Avodart is a 5-alpha-reductase inhibitor.
For The Record
Los Angeles Times Monday, May 19, 2008 Home Edition Health Part F Page 4 Features Desk 2 inches; 79 words Type of Material: Correction
Enlarged prostate: An article in the May 12 Health section about treatments for prostate enlargement gave inaccurate descriptions of two drugs used to treat the condition. The article said the drug dutasteride (Avodart) is an alpha blocker, used to relax muscles in the prostate and bladder. It also said tamsulosin (Flomax) is in a class of drugs called 5-alpha-reductase inhibitors, used to help shrink the prostate. In fact, Flomax is an alpha blocker, and Avodart is a 5-alpha-reductase inhibitor.
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A 2003 study already has revolutionized the standard of care men get for this common condition. And new ideas about treating the symptoms of prostate gland enlargement now have doctors treating men with drugs better known for their effects on erectile dysfunction and wrinkled skin.
Viagra and Botox are just two of several drugs being studied for treating problems with urination and benign prostatic hyperplasia, the term for overgrown but noncancerous prostates that occur in most men as they age.
The oft-reported numbers are startling: At least 2 of 3 sixtysomething men have symptoms of an enlarged prostate gland, the organ that produces semen. Symptoms can be merely bothersome -- the need to urinate often, poor urine flow and incomplete emptying of the bladder. Or they can be serious enough to require treatment: bladder and kidney dysfunction; stones or infection in the bladder; and urinary retention -- inability to urinate at all.
Drug use is fairly recent
Using drugs to treat enlarged prostates is fairly new. "Twenty years ago, we never used medications," says Dr. Steven Kaplan, a urologist at Weill Cornell Medical College in New York. Instead, when the condition became advanced, surgeons would cut away excess tissue.
Then a five-year study of 3,047 men published in the New England Journal of Medicine in 2003 caused a shift in medical practice. It found that a combination of two drugs helped relieve symptoms and halted the progression of the condition. "Now medications are the standard of care," says Kaplan, a coauthor of that research. Surgery is now reserved for men with very large prostates or intractable symptoms.
One of the drugs tested in that study is doxazosin (Cardura), which relaxes muscle in the prostate and bladder. This helps men maintain a steady urine stream and empty their bladders more completely.
The other drug, finasteride (Proscar), blocks the synthesis of a hormone thought to spur prostate growth and can reduce prostate size.
