Benign Prostatic Hyperplasia (BPH)in Seoul, Korea

Benign Prostatic Hyperplasia (BPH), commonly known as an enlarged prostate, is a prevalent condition affecting men, particularly as they age. It involves the non-cancerous growth of prostate tissue, which can press on the urethra, leading to bothersome lower urinary tract symptoms (LUTS). While surgical options exist, medication is often the first line of treatment for managing BPH symptoms in Korea, offering effective relief for many men.


Understanding Benign Prostatic Hyperplasia (BPH)

The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate enlarges with age, it can obstruct the flow of urine, leading to a variety of uncomfortable symptoms.

Common Symptoms of BPH (LUTS) Include:

  • Frequent urination: Especially at night (nocturia).
  • Urgency: A sudden, strong urge to urinate that's hard to postpone.
  • Weak urine stream: Reduced force of the urinary stream.
  • Difficulty starting urination (hesitancy): A delay in starting the urine flow.
  • Straining to urinate: Needing to push or strain to empty the bladder.
  • Dribbling at the end of urination: Urine leakage after finishing.
  • Feeling of incomplete bladder emptying: Sensation that the bladder is still full after urinating.



Diagnosis of BPH in Korea

Before initiating medication, a comprehensive diagnosis is crucial to rule out other conditions (like prostate cancer, UTIs, or bladder stones) and assess the severity of BPH. In Korea, this typically involves:

  • Detailed Medical History and Symptom Assessment: Using questionnaires like the International Prostate Symptom Score (IPSS).
  • Physical Exam: Including a Digital Rectal Exam (DRE) to feel the prostate.
  • Urinalysis: To check for infection or blood.
  • Blood Tests: Including Prostate-Specific Antigen (PSA) to screen for prostate cancer and kidney function tests.
  • Uroflowmetry: A test to measure the strength and speed of your urine stream.
  • Post-Void Residual (PVR) Volume: Measuring the amount of urine left in the bladder after urination, typically with an ultrasound.


Medication Treatment Options for BPH in Korea

Once diagnosed, medication is often the initial treatment choice for mild to moderate BPH symptoms. Korean urologists utilize several classes of drugs, sometimes in combination, to provide effective symptom relief.

  1. Alpha-Blockers (α-Blockers):
  • How they work: These medications relax the smooth muscles in the prostate gland and the bladder neck, reducing the obstruction of urine flow and making it easier to urinate. They do not shrink the prostate but provide rapid symptom relief, often within days to weeks.
  • Common examples in Korea:
  • Tamsulosin (e.g., Harnal D, Sulosin D): A highly selective alpha-1A blocker, widely used in Korea. Studies in Korean patients have shown its efficacy in improving symptom scores and urine flow.
  • Alfuzosin: Another selective alpha-blocker.
  • Silodosin: A third-generation alpha-blocker, also used for BPH.
  • Doxazosin, Terazosin: Older generation alpha-blockers.
  • Side Effects: Common side effects can include dizziness, lightheadedness (especially upon standing due to a drop in blood pressure), retrograde ejaculation (semen going into the bladder instead of out), and headache.
  1. 5-Alpha Reductase Inhibitors (5-ARIs):
  • How they work: These drugs reduce the size of the prostate by blocking the conversion of testosterone to dihydrotestosterone (DHT), a hormone that promotes prostate growth. They are more effective for men with larger prostates. It takes longer to see results (typically 3-6 months) but they can reduce the risk of acute urinary retention and the need for surgery.
  • Common examples in Korea:
  • Finasteride (e.g., Proscar): Blocks one type of 5-alpha reductase.
  • Dutasteride (e.g., Avodart): Blocks both types of 5-alpha reductase, potentially offering a more complete reduction in DHT.
  • Side Effects: Can include sexual side effects such as decreased libido, erectile dysfunction, and ejaculatory dysfunction. They also lower PSA levels, which needs to be considered for prostate cancer screening.
  1. Combination Therapy:
  • For men with moderate to severe symptoms and larger prostates, combining an alpha-blocker with a 5-ARI is often more effective than either medication alone. This approach tackles both the relaxation of prostate muscles and the reduction of prostate size.
  • Example: A common combination prescribed in Korea is dutasteride plus tamsulosin. Real-world data from South Korea indicates that this combination therapy is frequently used and has a safety profile similar to monotherapy.
  1. PDE5 Inhibitors (Phosphodiesterase-5 Inhibitors):
  • While primarily known for treating erectile dysfunction, some PDE5 inhibitors (like tadalafil, Cialis) are also approved for the daily treatment of BPH symptoms, particularly if a man experiences both ED and BPH. They help relax smooth muscles in the bladder and prostate.
  1. Phytotherapy (Herbal/Plant Extracts):
  • Certain plant-based supplements, such as saw palmetto (Serenoa repens) extracts, are popular in some countries for BPH symptoms. While widely used, the scientific evidence for their efficacy is often less robust than for prescription medications.
  • Traditional Korean herbal medicines (like Ga-Gam-Nai-Go-Hyan - GGN) have also been studied for their potential to suppress BPH development, though these are typically used within the context of Traditional Korean Medicine practices.


When considering BPH medication treatment in Korea, a consultation with a qualified urologist is essential. They will evaluate your specific symptoms, prostate size, and overall health to determine the most appropriate medication or combination therapy, ensuring the best possible outcome for your prostate health and quality of life.