From the Guidelines
After treating prostatic issues, you should wait approximately 4-6 weeks before checking for treatment response, as recommended by the 2023 European Association of Urology guidelines 1. This waiting period allows for an accurate assessment of treatment efficacy and potential side effects.
- For patients undergoing pharmacotherapy, a review at 4-6 weeks after treatment initiation is crucial to determine treatment response and adjust the treatment plan as needed.
- Patients who receive 5-alpha-reductase inhibitors (5-ARIs) should be reviewed after 12 weeks and 6 months to assess their response and potential adverse effects.
- The follow-up evaluation should include a thorough history, International Prostate Symptom Score (IPSS), uroflowmetry, and post-void residual (PVR) volume, with additional tests such as frequency volume charts and PSA re-evaluation at 6 months for those on 5-ARIs, as outlined in the guidelines 1.
- It is essential to note that the follow-up schedule may vary depending on the individual patient's symptoms and treatment response, and the guidelines emphasize the importance of regular reviews to ensure optimal management of prostatic issues 1.
From the Research
Treatment of Prostatic Hyperplasia
- The treatment of benign prostatic hyperplasia (BPH) often involves the use of 5-alpha reductase inhibitors (5-ARIs) and alpha-blockers 2, 3, 4, 5.
- 5-ARIs, such as finasteride and dutasteride, reduce the serum and intraprostatic concentration of dihydrotestosterone (DHT), causing an involution of prostate tissue 2.
- Alpha-blockers, on the other hand, relax the smooth muscle in the prostate and bladder neck, improving urinary flow rates and reducing lower urinary tract symptoms (LUTS) 4, 5.
Combination Therapy
- Combination therapy with 5-ARIs and alpha-blockers has been shown to be effective in reducing the risk of acute urinary retention and BPH-related surgery 3, 4, 5.
- However, combination therapy has also been associated with a higher risk of erectile dysfunction and libido alterations compared to monotherapy with alpha-blockers or 5-ARIs 6.
- The choice of treatment should be based on the individual patient's symptoms, medical history, and potential side effects 3, 4, 5, 6.
Waiting Period to Check Lisa
- There is no specific information in the provided studies regarding the waiting period to check Lisa after treatment of prostatic hyperplasia.
- The studies focus on the efficacy and safety of different treatment options for BPH, but do not provide guidance on the timing of follow-up appointments or checks 2, 3, 4, 5, 6.