{"id":3202,"count":31,"description":"Benign\u00ed hyperplazie prostaty (BPH) je nezhoubn\u00e9 zv\u011bt\u0161en\u00ed prostaty, kter\u00e9 postihuje a\u017e 50 % mu\u017e\u016f nad 60 let a 80 % mu\u017e\u016f nad 80 let. Mezi p\u0159\u00edznaky pat\u0159\u00ed slab\u00fd proud mo\u010di, obt\u00ed\u017en\u00e9 zah\u00e1jen\u00ed mo\u010den\u00ed, p\u0159eru\u0161ovan\u00e9 mo\u010den\u00ed, no\u010dn\u00ed mo\u010den\u00ed (nykturie) a pocit ne\u00fapln\u00e9ho vypr\u00e1zdn\u011bn\u00ed \u2013 souhrnn\u011b ozna\u010dovan\u00e9 jako p\u0159\u00edznaky doln\u00edch mo\u010dov\u00fdch cest (LUTS). Modern\u00ed l\u00e9\u010dba vyu\u017e\u00edv\u00e1 t\u0159i t\u0159\u00eddy l\u00e9k\u016f samostatn\u011b nebo v kombinaci, s p\u0159id\u00e1n\u00edm tadalafilu 5 mg denn\u011b u mu\u017e\u016f s BPH a erektiln\u00ed dysfunkc\u00ed. V\u0161echny produkty MedsBase pro BPH jsou dod\u00e1v\u00e1ny spole\u010dnost\u00ed WHO-GMP certifikovan\u00fdch v\u00fdrobc\u016f<\/strong>.\n\nAlfa-blok\u00e1tory \u2014 prvn\u00ed volba pro \u00falevu od p\u0159\u00edznak\u016f.<\/strong> Selektivn\u00ed antagonist\u00e9 alfa-1 uvol\u0148uj\u00ed hladk\u00e9 svalstvo v prostat\u011b, hrdle mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e a mo\u010dov\u00e9 trubici, \u010d\u00edm\u017e zlep\u0161uj\u00ed pr\u016ftok a sni\u017euj\u00ed obstruk\u010dn\u00ed p\u0159\u00edznaky b\u011bhem 1\u20132 t\u00fddn\u016f. Nezmen\u0161uj\u00ed objem prostaty ani neovliv\u0148uj\u00ed dlouhodob\u00fd pr\u016fb\u011bh \u2013 pouze zm\u00edr\u0148uj\u00ed p\u0159\u00edznaky. Tamsulosin 0,4 mg (nejselektivn\u011bj\u0161\u00ed v\u016f\u010di prostat\u011b, nejm\u00e9n\u011b vedlej\u0161\u00edch \u00fa\u010dink\u016f na krevn\u00ed tlak) je skladem jako Urimax<\/a>, Urimax Capsule<\/a>, Tamsuheal<\/a>, a kombinovan\u00e9 formy Urimax-D<\/a> (s dutasteridem) a Urimax-F<\/a> (s finasteridem). Alfuzosin s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm 10 mg jako Monolosin<\/a>. Silodosin 8 mg (nejuroselektivn\u011bj\u0161\u00ed, nejm\u00e9n\u011b \u00fa\u010dink\u016f na krevn\u00ed tlak, ale nejvy\u0161\u0161\u00ed m\u00edra retrogr\u00e1dn\u00ed ejakulace) jako Temsunol<\/a>, Temsunol tobolky<\/a>, a kombinace Temsunol-F<\/a> a Temsunol-D<\/a>. Vedlej\u0161\u00ed \u00fa\u010dinky v t\u00e9to t\u0159\u00edd\u011b: z\u00e1vrat\u011b p\u0159i postaven\u00ed (zejm\u00e9na po prvn\u00ed d\u00e1vce), retrogr\u00e1dn\u00ed ejakulace, nosn\u00ed kongesce. D\u016fle\u017eit\u00e9: p\u0159ed operac\u00ed \u0161ed\u00e9ho z\u00e1kalu upozorn\u011bte anesteziologa (intraopera\u010dn\u00ed syndrom ochabl\u00e9ho duhovky).\n\nInhibitory 5-alfa-redukt\u00e1zy \u2013 pro redukci objemu prostaty.<\/strong> Finasterid 5 mg a dutasterid 0,5 mg blokuj\u00ed p\u0159em\u011bnu testosteronu na dihydrotestosteron, \u010d\u00edm\u017e sni\u017euj\u00ed objem prostaty p\u0159ibli\u017en\u011b o 20\u201325 % b\u011bhem 6\u201312 m\u011bs\u00edc\u016f. Sni\u017euj\u00ed riziko akutn\u00ed retence mo\u010di a pot\u0159ebu chirurgick\u00e9ho z\u00e1kroku. \u00daleva od p\u0159\u00edznak\u016f je pomalej\u0161\u00ed ne\u017e u alfa-blok\u00e1tor\u016f (3\u20136 m\u011bs\u00edc\u016f), ale ovliv\u0148uj\u00ed z\u00e1kladn\u00ed biologick\u00fd mechanismus. Finasterid 5 mg (p\u016fvodn\u00ed 5-ARI od MERCK) je skladov\u00e1n jako Proscar<\/a> a Proscalpin<\/a>. Dutasterid 0,5 mg jako Dutanol<\/a> a kombinace Dutas T<\/a> (s tamsulosinem). Formulace finasteridu 1 mg jsou uvedeny v na\u0161\u00ed L\u00e9\u010dba vypad\u00e1v\u00e1n\u00ed vlas\u016f u mu\u017e\u016f<\/a> kategorii \u2014 stejn\u00e1 molekula, jin\u00e1 d\u00e1vka. Vedlej\u0161\u00ed \u00fa\u010dinky: sn\u00ed\u017een\u00e9 libido (~3\u20135%), erektiln\u00ed dysfunkce (~3\u20135%), sn\u00ed\u017een\u00fd objem ejakul\u00e1tu, gynekomastie (vz\u00e1cn\u011b). N\u011bkte\u0159\u00ed mu\u017ei uv\u00e1d\u011bj\u00ed p\u0159etrv\u00e1vaj\u00edc\u00ed post-finasteridov\u00fd syndrom \u2014 proberte rizika p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby.\n\nPDE-5 inhibitory pro kombinovanou BPH + ED.<\/strong> Tadalafil 5 mg jednou denn\u011b je schv\u00e1len FDA pro BPH-LUTS (samostatn\u011b nebo v kombinaci s alfa-blok\u00e1torem). Zlep\u0161uje jak LUTS, tak erektiln\u00ed funkci u mu\u017e\u016f s ob\u011bma obt\u00ed\u017eemi \u2014 jednopilov\u00e9 \u0159e\u0161en\u00ed pro dva probl\u00e9my. Nab\u00edz\u00edme tadalafil v n\u00edzk\u00e9 d\u00e1vce pod r\u016fzn\u00fdmi zna\u010dkami uveden\u00fdmi v na\u0161em Tadalafil<\/a> katalogu a kombinace jako Tadalista<\/a> a Vidalista<\/a>. Vy\u0161\u0161\u00ed d\u00e1vky tadalafilu a dal\u0161\u00ed PDE-5 inhibitory najdete v \u0161ir\u0161\u00edm L\u00e9ky na ED<\/a> katalogu.\n\nJak vybrat.<\/strong> M\u00edrn\u00e9 p\u0159\u00edznaky (IPSS 30 ml nebo PSA > 1,4 ng\/ml (markery rizika progrese). T\u011b\u017ek\u00e9 p\u0159\u00edznaky (IPSS > 19) nebo recidivuj\u00edc\u00ed retence \u2192 kombinace alfa-blok\u00e1tor + 5-ARI \u00b1 doporu\u010den\u00ed k chirurgick\u00fdm mo\u017enostem (TURP, HoLEP, PVP, zvednut\u00ed prostatick\u00e9 uretry, ablace vodn\u00ed p\u00e1rou). Soub\u011b\u017en\u00e1 ED \u2192 zva\u017ete tadalafil 5 mg denn\u011b jako monoterapii nebo kombinaci.\n\nD\u016fle\u017eit\u00e9.<\/strong> Akutn\u00ed retence mo\u010di (n\u00e1hl\u00e1 \u00fapln\u00e1 neschopnost mo\u010dit s bolestiv\u00fdm rozta\u017een\u00edm mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e) je urologick\u00e1 pohotovost \u2014 vyhledejte pohotovostn\u00ed odd\u011blen\u00ed. Nov\u011b vznikl\u00e1 hematurie, perine\u00e1ln\u00ed bolest, \u00fabytek hmotnosti nebo vzestup PSA nad o\u010dek\u00e1van\u00fd v\u011bkov\u00fd rozsah vy\u017eaduj\u00ed neodkladn\u00e9 urologick\u00e9 vy\u0161et\u0159en\u00ed k vylou\u010den\u00ed karcinomu prostaty. Testov\u00e1n\u00ed PSA je samostatn\u00e9 rozhodnut\u00ed, kter\u00e9 je t\u0159eba probrat s praktick\u00fdm l\u00e9ka\u0159em \u2014 l\u00e9\u010dba BPH 5-ARI sni\u017euje PSA p\u0159ibli\u017en\u011b o 50 %, co\u017e je t\u0159eba zohlednit p\u0159i interpretaci sledov\u00e1n\u00ed. Vyhn\u011bte se pod\u00e1v\u00e1n\u00ed alfa-blok\u00e1tor\u016f pacient\u016fm u\u017e\u00edvaj\u00edc\u00edm inhibitory PDE-5 v pln\u00fdch d\u00e1vk\u00e1ch bez revize d\u00e1vkov\u00e1n\u00ed (riziko aditivn\u00ed hypotenze).\n\nV\u0161echny produkty MedsBase pro BPH jsou odes\u00edl\u00e1ny z WHO-GMP certifikovan\u00fdch v\u00fdrobc\u016f<\/strong> s diskr\u00e9tn\u00edm balen\u00edm a jsou kryty na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>.","link":"https:\/\/medsbase.com\/cs\/benign-prostatic-hyperplasia-bph-treatment\/","name":"L\u00e9\u010dba benign\u00ed hyperplazie prostaty (BPH)","slug":"benign-prostatic-hyperplasia-bph-treatment","taxonomy":"product_cat","parent":3142,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3202","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3142"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product?product_cat=3202"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}