The changing therapy of benign prostatic hyperplasia.

The diagnosis and treatment of benign prostatic hyperplasia (BPH) is increasingly under review and discussion. The diagnosis of BPH can be based on microscopic, clinical, or urodynamic criteria, and has important implications for treatment. Recommendations for treatment regimens are regularly updated, as new therapies enter the market and the cost effectiveness of new and established regimens are reviewed. Surgery, the mainstay of treatment for BPH, is declining, and medical therapy is assuming a greater role. Pharmacological regimens, for example alpha adrenoceptor blockers and 5-alpha reductase inhibitors, are becoming established for the treatment of mild and moderate symptoms of BPH. This paper will review the spectrum of BPH treatment modalities facing the urologist, and the factors that influence individual treatment choice.