Which medication class should be avoided in patients with benign prostatic hyperplasia (BPH) due to the risk of urinary retention?

The medication class that should be avoided in patients with benign prostatic hyperplasia (BPH) due to the risk of urinary retention is antihistamines. Antihistamines work by blocking histamine receptors, which can lead to anticholinergic effects. These effects can cause relaxation of the bladder and increased urinary retention, which exacerbates symptoms in patients with BPH who may already struggle with urinary flow due to prostate enlargement.

In patients with BPH, the goal is often to relieve urinary symptoms and improve bladder emptying. The use of antihistamines can counteract this by causing additional difficulty in urination.

Other medication classes, while they may have some effects on urinary function, do not carry the same level of risk for urinary retention associated with antihistamines. For example, beta-blockers can be used cautiously and may even help reduce urinary symptoms by improving blood flow and reducing pressure on the bladder. Diuretics can lead to increased urination but do not directly cause urinary retention, and ACE inhibitors generally do not have a significant impact on urinary function in the context of BPH. Thus, antihistamines are specifically known for their association with urinary retention issues in this patient demographic.