The aim of therapy for benign prostatic hyperplasia. (BPH) is to improve quality of life by providing symptom relief and an increased maximum flow rate, as well as reduce disease progression and the development of new morbidities. There has been an enormous decline in the popularity of surgery and it is now apparent that medication is the most frequently used treatment for BPH. This has arguably therefore been the most major change in urological clinical practice in the last decade. Currently α1-adrenoceptor antagonists are the commonest medical therapy, and are thought to act by relaxing prostatic smooth muscle, the neural or so-called 'dynamic' component of BPO. 5 α-reductase inhibitors are another option for BPH, which reduce prostatic mass and therefore the mechanical or 'static' component of benign prostatic obstruction (BPO). Another group of agents are the phytotherapeutic extracts, which act via various mechanisms, many as yet poorly defined. This review critically assesses existing publications relating to the medical management of BPH.
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