Role of long-acting selective alpha-1 blockers in the treatment of benign prostatic hyperplasia.

Alpha blockers are effective for the treatment of symptomatic BPH, although the long-term response to and compliance with alpha blockers remain critical issues. The ultimate role of alpha blockade for the management of symptomatic BPH is undefined pending their resolution. The effectiveness of nonselective alpha blockers such as phenoxybenzamine is counterbalanced by the incidence and severity of adverse reactions. Selective alpha blockers such as prazosin and terazosin are far better tolerated while providing similar degrees of subjective and objective relief of bladder outlet obstruction. The preliminary experience with alpha blockers demonstrates statistically and clinically significant improvements in the symptoms of prostatism and urinary flow rates, and the majority of patients receiving alpha blockers have been extremely satisfied. The data on alpha blockers are preliminary, and therefore the role of these drugs at present must be decided upon by the individual urologist. There is sufficient evidence to justify the use of alpha blockers for men with moderate symptoms of prostatism, yet urologists may validly interpret the clinical experience with alpha blockers as preliminary. Nevertheless, urologists should at least present this option to patients before performing a prostatectomy. The patients selected for alpha blockade must be advised that the drugs alleviate the symptoms of prostatism rather than permanently reversing the pathophysiology of BPH.(ABSTRACT TRUNCATED AT 250 WORDS)

RCT Entities:   Population Interventions Outcomes