Drug therapy for benign prostatic hyperplasia.: Systematic overview

5a-Reductase inhibitors and a(1)-receptor blockers are established options for symptomatic treatment of benign prostatic hyperplasia (BPH). Achieving maximum efficacy is contingent on correct dosage and requires careful patient selection in view of the substance class employed. All applicable preparations exert only a low-grade effect on prostatic obstruction. This condition should be excluded by appropriate urological examination before treatment is initiated. If the patient's distress is minor, refraining from drug therapy can be considered. Symptomatic patients with small prostate volume are suited for monotherapy with a(1)-receptor blockers and symptomatic patients with large prostate volume profit from combination therapy. When 5a-reductase inhibitors are used, BPH patients should be made aware of the findings from the Prostate Cancer Prevention Trial.