alpha(1)-Blockade in the nineties: focus on the patient

Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are prevalent in 14-19% of men in their 40s, increasing to 43% in men >60 y. Symptoms impact on patient's quality of life to varying degrees and more recently have been shown to affect sexual function. A number of question-naires are available which can assess symptom severity, quality of life and sexual function. Comparative studies in different countries show a similar trend, in that as symptom severity increases, then so does the interference with quality of life, general health status and sexual function. Treatment of LUTS is associated with an improvement in the quality of life of the patient. alpha(1)-Blockers are an established treatment of LUTS associated with BPH and, in addition, the alpha(1)-blocker alfuzosin has been shown to improve sexual drive and function. It is not yet known, however, whether this is a direct effect or due to a general improvement in the patient's quality of life. When treating BPH, physicians should be aware of the quality of life aspects to the disease, including sexual function, which is still an important feature in the ageing male.