Management of Benign Prostatic Hyperplasia

Abstract

Objective:

To review the physiology and pathophysiology of benign prostatic hyperplasia, as well as current medical strategies for the management of the disease.

Data Sources:

A MEDLINE search (1992–September 2004) was conducted using benign prostatic hyperplasia (BPH), α-receptor antagonists, and 5 α-reductase inhibitors as MeSH search terms to identify clinical trials and review articles.

Study Selection/Data Extraction:

Primary literature and tertiary review articles evaluating the safety and efficacy of pharmacotherapeutic options in the management of benign prostatic hyperplasia were retrieved and included.

Data Synthesis:

Pharmacotherapeutic management of symptoms associated with benign prostatic hyperplasia has become the hallmark of therapy. Therapeutic agents evaluated include α-adrenergic antagonists (prazosin, terazosin, doxazosin, alfuzosin, tamsulosin) and 5-α-reductase inhibitors (finasteride, dutasteride). α-Adrenergic antagonists are more popular for therapy of BPH. This group of drugs is generally the first line of therapy, with growing popularity of tamsulosin and alfuzosin due to their decreased incidence of adverse effects.

Conclusions:

Understanding the pathophysiology of the disease can play an integral part in the selection of a pharmacotherapeutic agent. Patients who require pharmacologic intervention can benefit greatly by the number of agents available.