Potentials for the combined therapy of urination disorders in men: the choice of optimal scheme of treatment
Moderate to severe urination disorders occur in 13-29% of men, and their frequency increases progressively with age. The key for successful use of the capabilities of modern drug therapy is the understanding of the pathophysiological bases of urination disorders. Despite some successes of monotherapy with а- adrenoblockers and 5<r-reductase inhibitors, combined use of drugs is appropriate, because the differences in mechanisms of action allows to simultaneously act on the smooth muscle tissue, causing its relax, and reduce the size of prostate by the induction of apoptosis, which ultimately allows to expect the maximum therapeutic effect. The goal of therapy in patients with BPH is not only a reduction in the severity of urination disorders, but the prevention of disease progression. Obviously, urination disorders in men are not always caused by an benign prostate hyperplasia. Hyperactive symptoms (primary and secondary, due to metabolic disorders in detrusor against the background of prolonged existence of bladder outlet obstruction) are revealed in significant proportion of men. In this cases, the use of M-anticholinergics is indicated. Administration of α-adrenoblockers and antimuscarinic drugs is one of potential variant of combined therapy. Thus, it is important to follow the principles of selectivity in patients with urination disorders. Modern pharmacotherapy has an arsenal of drugs, allowing to choose the drug therapy for patients with urination disorders depending on the prevalence of their types.