Which class of medications should be avoided in men with BPH?

Men with benign prostatic hyperplasia (BPH) often experience symptoms related to urinary obstruction due to the enlargement of the prostate. In this context, certain classes of medications can exacerbate these symptoms or hinder urinary flow.

Decongestants, which include medications containing pseudoephedrine or phenylephrine, can lead to urinary retention and worsen symptoms associated with BPH. They exert their effects by stimulating alpha-adrenergic receptors, which can cause contraction of the smooth muscle in the prostate and bladder neck, leading to increased resistance to urine flow. This is particularly problematic in patients with BPH, as they may already be struggling with urinary difficulties.

In contrast, antihypertensives, antibiotics, and diuretics do not have this adverse effect on urinary flow in the same way decongestants do. Antihypertensives can sometimes even help with symptoms, as certain types (like alpha-blockers) can relax prostate and bladder neck muscles. Antibiotics treat infections and generally do not interfere with urinary outflow. Diuretics can lead to increased urinary frequency, but they do not cause urinary retention or worsen symptoms of BPH in the same direct way that decongestants might.

Thus, decon