ALPHA(1)-BLOCKERS VS 5-ALPHA-REDUCTASE INHIBITORS IN BENIGN PROSTATICHYPERPLASIA - A COMPARATIVE REVIEW

During recent years, pharmacological treatment of symptomatic benign p rostatic hyperplasia (BPH) has become the primary treatment choice for an increasing number of patients, The 2 principal drug classes employ ed are alpha 1-blockers and 5 alpha-reductase inhibitors, Current info rmation from placebo-controlled double-blind clinical trials is review ed, The effect of alpha 1-blockers on symptoms and objective parameter s for bladder outlet obstruction is well documented, However, alpha 1- blockers carry a small but significant incidence of adverse effects, P arameters for identification of patients who will respond well to alph a 1-blockers have yet to be identified, and data concerning the long t erm effects of these drugs are not yet available. 5 alpha-Reductase in hibitors have a slow onset of effect, but treatment leads to improveme nt in symptoms, reduction of the size of the prostate gland and improv ement in objective parameters for bladder outflow obstruction, Approxi mately 30 to 50% of patients will respond to treatment with 5 alpha-re ductase inhibitors. The definitive role of pharmacological treatment i n symptomatic BPH remains to be established, although it seems that pa tients unfit or unwilling to undergo surgical resection of the prostat e will benefit from such therapy.