Benign Prostatic Hyperplasia

What drug treatments are available?

Pharmacological treatment is reserved to patients with bothersome lower urinary tract symptoms (LUTS) and/or complications of the disease, whereas surgical therapies may be indicated in the most severe cases, when BPH significantly impairs quality of life. A variety of pharmacologic classes are employed including alpha-adrenergic antagonists (alpha- blockers), 5-alpha- reductase inhibitors (5-ARIs) and anticholinergics. Alpha-blockers represent a class of drugs that acts relaxing the muscles of the prostate and bladder neck and increasing urinary flow. The effect of alpha-blocker is often visible within a few days after starting treatment. Treatment with 5-ARIs, commonly used in combination with alpha-blockers, can help reduce the volume of the prostate gland. However, it may take several months before benefit from these drugs is noted.. In addition to treating erectile dysfunction, phosphodiesterase-5 inhibitors may also alleviate lower urinary tract symptoms (LUTS) trough a specific mechanism of relaxation of the prostatic urethra and/or bladder neck. Phytotherapeutic agents (e.g. Serenoa repens) are considered emerging therapy by the AUA Guidelines: compared to conventional pharmacological treatments, they showed lower adverse effects and similar improvements at least in quality of life and symptoms in patients with LUTS/BPH in conditions of current clinical practice.


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