McIver Urological Clinic

	Herbal Therapy Herbal therapies can be purchased at several vitamin stores. All generally contain Saw Palmetto, a natural substance, and multiple other natural ingredients. The mechanism of action of these formulations are unknown. Despite the claims of these various formulations, no good controlled studies on the effectiveness of these medications have been done. In fact, a recent article in the New England Journal of Medicine questioned the benefits of Saw Palmetto therapy. Nevertheless, aside from cost, these medications generally have few side effects or disadvantages. Some patients claim excellent relief.

	Medications that Relax the Prostate These medications (also known as the alpha-blockers) relax the ‘muscular’ tissues around the bladder neck and prostate. The relaxation of these tissues helps open the channel resulting in improved voiding. Common medications include Flomax, Uroxatrol, Hytrin and Cardura. Results are often seen within one to two weeks. Side effects include dizziness, lightheadedness, and decrease in semen which occur in some patients.

	Medications that Shrink the Prostate These medications (also known as the 5-alpha reductase inhibitors) work by inhibiting the formation of dihydrotestoterone, a hormone responsible for prostate growth. The ‘shrinking’ of the prostate is not immediate, and these medicines take a minimum of three to six months to work. They do, however, reverse nature’s course- to a degree. They have been shown to reduce the risk of urinary retention and the risk of prostate surgery. Medications include Avodart and Proscar. Side effects include impotence, a decrease in sexual interest (libido) and reduced semen volume which occur in some patients.