LHRH agonists. A nonsurgical treatment for benign prostatic hyperplasia.

摘要: Luteinizing hormone-releasing hormone (LHRH) agonist, when administered in a continuous, nonpulsatile manner, causes desensitization of the LHRH receptor complex on gonadotroph cells anterior pituitary gland. Biosynthesis and secretion luteinizing cease, testicular androgenic production is inhibited. When used this capacity, agonists can be an effective treatment for benign prostatic hyperplasia. After 4 to 6 months therapy, volume decreases by 25% 30%, voiding symptoms improve significantly approximately 33% patients, peak urinary flow rate increases substantially (more than 15 ml/second) patients. During first month treatment, serum hormone, follicle-stimulating testosterone, dihydrotestosterone, 17 beta-estradiol, prostate-specific antigen decline low values remain throughout treatment. Prostatic 5 alpha-reductase activity androgen content also decrease with Side effects are significant: impotence, decreased libido, hot flushes most common. Because effect agonist therapy testosterone concentration reversible, hyperplasia must considered life-long therapy. Thus, should reserved patients who impotent or poor surgical risks.