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01.03.2009 | Leitthema

Behandlung von Miktionsstörungen bei BPS

Wann Pillen und wann nicht?

verfasst von: Dr. R. Berges

Erschienen in: Die Urologie | Ausgabe 3/2009

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Zusammenfassung

Das benigne Prostatahyperplasiesyndrom (BPS) ist eine Ausschlussdiagnose und verlangt eine dezidierte Diagnostik. Der Ausschluss einer signifikanten Obstruktion gehört zum wichtigsten Baustein dieser Diagnostik vor jeder Medikation. Charakteristika der einzelnen BPS-Medikamente und die multifaktorielle Genese von Symptomen bei BPS implizieren ein individualisiertes Therapieschema. LUTS (lower urinary tract symptoms) bei kleiner Prostata und vorwiegende Speichersymptome sind Domäne der α₁-Rezeptorenblocker. Bei führender OAB-Syptomatik ist eine Kombination mit Muskarinrezeptorantagonisten möglich.

Ist eine BPS-Therapie langfristig ausgerichtet und soll eine Progression verhindert werden, kann die Kombination von α₁-Rezeptorenblockern mit einem 5α-Reduktasehemmer sinnvoll sein, vorausgesetzt, das Prostatavolumen ist ausreichend groß. Alter, stark ausgeprägte Basalsymptome und große Prostata bzw. hoher PSA-Wert sind Risiken für die klinische Progression. Generell gilt, eine Kombinationstherapie verstärkt Nebenwirkungen – eine Nutzen-Risiko-Abschätzung ist daher notwendig. Das Potential aller BPS-Medikamente zur Behandlung der Obstruktion ist gering. Ist Deobstruktion ein vordringliches Therapieziel, eignen sich Medikamente oder Kombinationen aus Medikamenten eher nicht.

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Titel: Behandlung von Miktionsstörungen bei BPS
Wann Pillen und wann nicht?
verfasst von: Dr. R. Berges
Publikationsdatum: 01.03.2009
Verlag: Springer-Verlag
Erschienen in: Die Urologie / Ausgabe 3/2009
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI: https://doi.org/10.1007/s00120-009-1980-x

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