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The authors propose the use of alpha-blockers and 5 alpha-reductase inhibitors for the management of benign prostatic syndrome. As another group of substances for therapeutic use, I would suggest secretolytics and mucolytics. The prostate of elderly men often contains leukocyte permeated secretion masses in dilated glandular ducts (1). Mucoproteins are one of the constituents of prostatic secretion. In addition, the tissue pressure of the prostate is significantly increased in patients with chronic abacterial prostatitis (2). Elevated tissue pressure might conceivably be causally implicated in the pain associated with this condition. Mucoproteins are a constituent of prostatic secretion, and mucolytics could reduce the elevated tissue pressure. Mucoproteins contain disulfide bonds that can be cleaved by the free sulfhydryl group, for instance of the mucolytic agent acetylcysteine. In saliva, glycoproteins are depolymerized by cleavage of the disulfide bridges, which reduces the viscosity of the sputum. Should
it also be possible to lower the viscosity of prostatic secretion by depolymerization of various components, outflow could be improved. After many years of suffering considerable symptoms of abacterial prostatitis, I took 2 x 600 mg ACC as a self-experiment. The symptoms improved within two hours and symptom remission was complete after two days. The PSA value normalized simultaneously (for details see my list of references: www.kyb.mpg.de). Secretolytics/mucolytics could conceivably also improve the symptoms of benign prostatic syndrome.