Question

Discuss the underlying pathophysiology of benign prostatic hyperplasia (BPH) and relate it to the mechanism of action of 5-alpha-reductase inhibitors and alpha blockers.

Answer 1

hyperplastic process that occurs in the gland. Hyperplasia is a result of the swollen prostate, which blocks the normal flow of urine from the bladder through the urethra to be expelled. The prostate enlargement is faced as a normal part of male aging, while the most typical explanation for the disease focus on the fact that the swollen gland cannot radially expand due to the surrounding capsule, but it can compress the urethra. .Normal prostate development as well as BPH progression occurs under the influence of dihydrotestosterone (DHT), which is a derivative of testosterone with a higher affinity for the androgen receptor . The conversion of testosterone to DHT occurs by the enzyme 5-alpha reductase; therefore, DHT production can be inhibited by 5-ARIs. Although both commercially available 5-ARIs are 4-azasteroids that behave as selective, irreversible inhibitors of 5-alpha reductase, dutasteride inhibits both isoenzymes of 5-alpha reductase (types 1 and 2), while finasteride only inhibits 5-alpha reductase type 2 also studies have demonstrated that dutasteride is a 45 times more potent inhibitor of 5-alpha reductase type 1 and a 2.5 times more potent inhibitor of 5-alpha reductase type 2, when compared to finasteride .