Tratamiento farmacológico en la hiperplasia prostática benigna

benign prostatic hyperplasia is a common disease in over 50 years-old men consisting in uncontrolled and benign growth of prostatic gland that leads to lower urinary tract symptoms. the etiology of benign prostatic hyperplasia is multifactoral involving the increased conversion of testosterone in dihydrotestosterone by the prostatic 5a-reductase action, which brought about events that encourage the prostate growth (static component) and the increase of the bladder and prostate smooth muscle tone (dynamic component) regulated by the a1 -adrenoceptors (adr). the pharmacological treatment of the benign prostatic hyperplasia includes the prostatic 5a-reductase inhibitors, the a1-adrenoreceptor blockers, their combined therapy and the phytotherapy. this paper was aimed at presenting the most relevant aspects of the pharmacology of drugs used for treating the benign prostatic hyperplasia, and providing elements to analyze their efficacy, safety and tolerability. to this end, a review was made of the different drugs for the treatment of this pathology and they were grouped according to their mechanism of action. natural products were included as lipid extracts from serenoa repens and pygeum africanum as well as d-004, a lipid extract from roystonea regia fruits, with proved beneficial effects on the main etiological factors of benign prostatic hyperplasia. d-004 is a prostatic 5a-reductase inhibitor, an a1-adrenoceptor antagonist, a 5-lipooxygenase inhibitor and has antioxidant action, all of which reveals a multifactoral mechanism. the results achieved till now indicate that d-004 is a safe and well-tolerated product.