Benign prostatic hyperplasia (BPH) is a common urological disease that is strongly associated with the aging process and can lead to lower urinary tract symptoms (LUTS). LUTS due to BPH can significantly affect the quality of life of many patients. Among the treatments available for BPH to improve symptoms and functional outcomes, drug therapy and surgical therapy are the options of choice. However, for most patients with symptomatic BPH, medical management remains the cornerstone of treatment. Pharmacologic interventions are often preferred as a first approach, being less invasive compared to surgery. Although the medical treatment of BPH is currently defined by the algorithms of international guidelines, the need for a more personalized approach is increasingly recognized given the wide and heterogeneous range of therapeutic options available.
A review of medical therapy for BPH was conducted using relevant articles in PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. In this review, all drug treatments currently available on the international market whose efficacy is scientifically proven are reviewed and described (phytotherapy, alpha-blockers, muscarinic receptor antagonists, 5-alpha-reductase inhibitors, combination therapies, etc.).
A total of 17 randomized clinical trials were selected for review. Further, 75 studies were included for analysis and discussion.
As the treatment landscape continues to evolve, tailoring therapy to individual patient needs and preferences is likely to become increasingly important to ensure that treatment strategies are both effective and meet patient expectations.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2024 Dec 18*** epublish ***
Guglielmo Mantica, Francesca Ambrosini, Giovanni Drocchi, Zlata Zubko, Lorenzo Lo Monaco, Angelo Cafarelli, Alessandro Calarco, Renzo Colombo, Ottavio De Cobelli, Ferdinando De Marco, Giovanni Ferrari, Giuseppe Ludovico, Stefano Pecoraro, Domenico Tuzzolo, Carlo Terrone, Rosario Leonardi
Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa; IRCCS Ospedale Policlinico San Martino, Genoa. ., IRCCS Ospedale Policlinico San Martino, Genoa. ., Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa. ., Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa. ., Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa. ., Urology Unit, Villa Igea, Ancona . ., Department of Urology, San Carlo di Nancy Hospital, Rome. ., Department of Urology, Vita e Salute San Raffaele University, Milan. ., Department of Urology, IEO European Institute of Oncology, IRCCS, Milan. ., I.N.I. Grottaferrata, Rome . ., Hesperia Hospital, Modena . ., Ospedale Miulli, Acquaviva delle Fonti, Bari . ., NEUROMED, Avellino . ., Urologi Ospedalità Gestione Privata (UrOP) . ., Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy IRCCS Ospedale Policlinico San Martino, Genova, Italy. ., Casa di Cura Musumeci-Gecas, 95030 Gravina di Catania. .