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CAPÍTULO 58 HIPERPLASIA BENIGNA DE PRÓSTATA 635

Doxazosina, 1 mg al acostarse, y ajustar hasta existen contraindicaciones para utilizarlos
un máximo de 8 mg. conjuntamente.

Tamsulosina, 0,4 mg, y ajustar hasta un
máximo de 0,8 mg.
■ Cirugía
• Cuando persisten o empeoran los
• Si el paciente es incapaz de tolerar un
síntomas del paciente a pesar de las
bloqueador α, contemplar el uso de A A 2 2
finasterida, 5 mg/día. medidas precedentes, se le debe derivar
para una evaluación y tratamiento
urológico:
• Tratamiento combinado: en un Veterans
Cooperative Study no se observaron
efectos beneficiosos adicionales al agregar TMTU B B 2 2
finasterida a un bloqueador α . La
22
combinación de bloqueadores α y RTUP
fitoterapia no se ha estudiado, si bien no A A 3 3

BIBLIOGRAFÍA 12. Fahim M, Fahim Z, Der R, Harman J: Zinc treatment for the
reduction of hyperplasia of the prostate. Fed Proc 35:361, 1976
1. Hammarsten J, Hogstedt B, Holthuis N, Mellstrom D: Components of 13. Leake A, Chisholm GD, Habib FK: The effect of zinc on the
the metabolic syndrome: Risk factors for the development of benign 5-α-reduction of testosterone by the hyperplastic human prostate
prostatic hyperplasia. Prostate Cancer Prostatic Dis 1:157-162, 1998. gland. J Steroid Biochem 20:651-655, 1984.
2. Rohrmann S, Smit E, Giovannucci E, Platz EA: Association between 14. Leake A, Chisholm GD, Busuttil A, Habib FK: Subcellular
markers of the metabolic syndrome and lower urinary tract distribution of zinc in the benign and malignant human prostate:
symptoms in the Third National and Nutrition Examination Survey Evidence for a direct zinc androgen interaction. Acta Endocrinol
(NHANES III). Int J Obes Relat Metab Disord 29:310-16, 2004. 105:281-288, 1984.
3. Ptatz EA, Rimm EB, Kawachi I, et al: Alcohol consumption, cigarette 15. Carraro JC, et al: Comparison of phytotherapy with finasteride in
smoking, and risk of benign prostatic hyperplasia. Am J Epidemiol the treatment of benign prostate hyperplasia: A randomized
149:106-115, 1999. international study of 1098 patients. Prostate 29:231, 1996.
4. Sierksma A, Patel H, Ouchi N, et al: Effect of moderate alcohol 16. Gerber GS, et al: Saw palmetto in men with lower urinary tract
consumption on adiponectin, tumor necrosis factor alpha, and symptoms: Effects on urodynamic parameters and voiding
insulin sensitivity. Diabetes Care 27:184-189, 2004. symptoms. Urology 51:1003-1007, 1998.
5. Sierksma A, Sarkola T, Eriksson CJ, et al: Effect of moderate alcohol 16a. Bert S, Kane C, Shinohara K, et al: Saw palmetto for benign prostatic
consumption on plasma dehydroepiandrosterone sulfate, hypertrophy. N Engl J Med 354:557-566, 2006.
testosterone, and estradiol levels in middle aged men and 17. Buck AC, Cox R, Rees RW, et al: Treatment of outflow tract
postmenopausal women: A diet-controlled intervention study. obstruction due to benign prostatic hyperplasia with the pollen
Alcohol Clin Exp Res 28:780-785, 2004. extract, Cernilton: A double-blind, placebo-controlled study. Br J
6. Chan JM, Gann PH, Giovannucci EL: Role of diet in prostate cancer Urol 66:398-404, 1990.
development and progression. J Clin Oncol 23:8152-8160, 2005. 18. Habib FK, Ross M, Lewenstein A, et al: Identification of a prostate
7. Berges RR, Windeler J, Trampisch HJ, et al: Randomised, placebo- inhibitory substance in a pollen extract. Prostate 26:133-139,
controlled, double-blind clinical trial of beta-sitosterol in patients 1995.
with benign prostatic hyperplasia. Lancet 345:1529-1532, 1995. 19. Loschen G, Ebeling L: Inhibition of arachidonic acid cascade by
8. Pizzorno JE, Murray MT. Benign prostatic hyperplasia. In Textbook extract of rye pollen [German]. Arzneimittelforschung 41:162-167,
of Natural Medicine, 2nd ed. Edinburgh, Churchill Livingstone, 1991.
1999, pp 1147-1152. 20. Becker H, Ebeling L: Conservative therapy for benign prostatic
© Elsevier. Es una publicación MASSON. Fotocopiar sin autorización es un delito.
9. Padayatty SJ, Marcelli M, Shao TC, Cunningham GR: Lovastatin- hyperplasia (BPH) with Cernilton. Br J Urol 66:398-404, 1988.
induced apoptosis in prostate stromal cells. J Clin Endocrinol Metab 21. Ishani A, MacDonald R, Nelson D, et al: for the treatment of
82:1434-1439, 1997. patients with benign prostatic hyperplasia: A systematic review and
10. Klippel KF, Hiltl DM, Schipp B: A multicentric, placebo-controlled, quantitative meta-analysis. Am J Med 109:654-664, 2000.
double-blind clinical trial of β-sitosterol (phytosterol) for the treatment 22. Lepor H, Williford WO, Barry MJ, et al: The efficacy of terazosin,
of benign prostatic hyperplasia. Br J Urol 80:427-432, 1997. finasteride, or both in benign prostatic hyperplasia. Veterans Affairs
11. Wilt T, Ishani A, Mac Donald R, et al: Beta-sitosterols for benign Cooperative Studies Benign Prostatic Hyperplasia Study Group.
prostatic hyperplasia. Cochrane Database Syst Rev (3):CD001043, 1999. N Engl J Med 335:533-539, 1996.