Benign Prostatic Hyperplasia: The Daily PANCE Blueprint

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Benign Prostatic Hyperplasia: The Daily PANCE Blueprint

A 66-year-old man has frequency, nocturia, hesitancy, a weak stream, and a smoothly enlarged, non-tender prostate, and is started on tamsulosin with rapid relief. Tamsulosin works primarily by which mechanism?

A. 5-alpha-reductase inhibition
B. Muscarinic (anticholinergic) blockade
C. Alpha-1 adrenergic receptor blockade
D. Phosphodiesterase-5 inhibition
E. Androgen receptor antagonism

Answer and topic summary

The answer is C. Alpha-1 adrenergic receptor blockade.

Tamsulosin is an alpha-1 adrenergic antagonist that relaxes prostatic and bladder-neck smooth muscle, relieving the dynamic obstruction within days – which is why alpha-blockers are first-line for symptoms. 5-alpha-reductase inhibitors (finasteride) shrink the gland over months; antimuscarinics target overactive bladder and can worsen retention; PDE-5 inhibitors (tadalafil) help BPH plus erectile dysfunction; and androgen-receptor blockers are for prostate cancer.

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Covered under ⇒ PANCE Blueprint Genitourinary ⇒ Prostate Disorders ⇒ Benign Prostatic Hyperplasia

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