Review of current medical treatment of benign prostatic hyperplasia

Over the last 5-10 years new treatment modalities have appeared at an increasing pace. The emerging pharmacological treatment modalities have all been used on a large scale. The exact indications and limitations of these methods have not yet been definitely established. Careful analysis of the symptomatology is crucial in counselling the patient. The Danish prostatic symptom score model is proposed. However, treatment benefits should exceed harm and there must be a reasonable cost-effectiveness. The established clinical experience with pharmacological agents that reduce prostatic size and/or the tone in the prostate are effective in the treatment of benign prostatic hyperplasia. Selective alpha 1 blockers seem to be useful in patients with uncomplicated benign prostatic hyperplasia and mild to moderate symptoms. The side effects of hormone therapy are inhibitive for use in patients with a benign disease. Data currently available indicate a role for 5 alpha-reductase inhibitors yet to be defined.