Abstract
Therapy for benign prostatic hyperplasia has evolved rapidly over the last decade, with the introduction in the early 1990s of new agents such as α1-blockers and 5α-reductase inhibitors. The major advantage of α1-blockers over 5α-reductase inhibitors is their rapid onset of action. Maximum flow rate is improved after first administration and optimal symptom relief is usually reached within 2–3 months. In addition, α1-blockers are effective regardless of prostate size and they provide a similar degree of symptom relief in patients with or without bladder outlet obstruction. The main adverse events with the α1-blockers relate to their effects on the cardiovascular system (postural hypotension) and central penetration (asthenia, somnolence). Newer uroselective α1-blockers, such as alfuzosin and tamsulosin, have a better safety profile and, as such, do not require initial dose titration. Alfuzosin has also been shown in a six-month study to significantly reduce both residual urine and the incidence of acute urinary retention (AUR) compared with placebo. In addition, alfuzosin is effective in improving the success rate of a trial without catheter in patients with AUR.
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Höfner, K. α1-Blocker therapy in the nineties: focus on the disease. Prostate Cancer Prostatic Dis 2 (Suppl 4), S9–S15 (1999). https://doi.org/10.1038/sj.pcan.4500368
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DOI: https://doi.org/10.1038/sj.pcan.4500368