Review ArticlesEfficacy of a-Adrenergic Receptor Blockers in the Treatment of Male Lower Urinary Tract SymptomsAdvances in the Pharmacologic Treatment of BPHClaus G RoehrbornMale lower urinary tract symptoms (LUTS) are one of the most common causes for a consultation with a health care provider, and one of the most common causes of male LUTS is benign prostatic hyperplasia (BPH). In recent decades, medical therapy has established itself as viable and cost effective for the majority of men. For the treatment of male LUTS in the United States, the 5 currently available α-adrenergic receptor blockers are alfuzosin, doxazosin, silodosin, terazosin, and tamsulosin. α-Blockers remain one of the mainstays in the treatment of male LUTS and clinical BPH. They exhibit an early onset of efficacy (within less than 1 week) with regard to both symptoms and flow rate improvement, maintain such improvements in open-label and controlled trials for up to 5 years, and have been shown to prevent symptomatic progression.[Rev Urol. 2009;11(suppl 1):S1–S8 doi: 10.3909/riu11S1S0003]© 2009 MedReviews®, LLCBenign prostatic hyperplasiaLower urinary tract symptomsBlockers
Reviews in UrologyPathophysiology of Benign Prostatic Hyperplasia: Insights From Medical Therapy for the DiseaseAdvances in the Pharmacologic Treatment of BPHHerbert LeporThe medical treatment of benign prostatic hyperplasia (BPH) has its roots in the early 1970s. During this era, the first clinical trials investigating α-blockade and androgen deprivation therapy were reported for men with clinical BPH. The observation that clinical BPH was improved following administration of both α-blockers and androgen deprivation therapy supported the evolving paradigm that clinical BPH resulted from dynamic and static pathways. During the past several decades, the evolution of α-blockers for the treatment of BPH has been impacted by innovations targeted to simplify the administration and improve tolerability while maintaining their effectiveness.[Rev Urol. 2009;11(suppl 1):S9–S13 doi: 10.3909/riu11S1S0002]© 2009 MedReviews®, LLCBladder outletobstructionSelectivityAdrenergic Receptors
Review ArticlesSide Effects of a-Blocker Use: Retrograde EjaculationAdvances in the Pharmacologic Treatment of BPHSteven A KaplanThere are currently 5 α-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all α-blockers are equally effective. However, α-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available α-blockers being used to treat men with LUTS due to benign prostatic hyperplasia.[Rev Urol. 2009;11(suppl 1):S14–S18 doi: 10.3909/riu11S1S0001]© 2009 MedReviews®, LLCBenign prostatic hyperplasiaLower urinary tract symptomsBlockers
Review ArticlesMedical Management of Lower Urinary Tract SymptomsAdvances in the Pharmacologic Treatment of BPHEric E LabordeKevin T McVaryLower urinary tract symptoms (LUTS) are a common complaint among aging men and are often caused by benign prostatic hyperplasia (BPH). A number of medical treatments for LUTS/BPH exist, such as α-blockers, 5α-reductase inhibitors, anticholinergics, phosphodiesterase type 5 (PDE5) inhibitors, and combination therapies. Agonist binding of the α1A-adrenergic receptor (AR), causing prostatic smooth muscle contraction, has been attributed to cause some LUTS. Therefore, medical therapy has aimed to block the α1A-AR and improve LUTS. Determining which therapy to choose must take into account individual patient factors as well as cost and patient choice.[Rev Urol. 2009;11(suppl 1):S19–S25 doi: 10.3909/riu11S1S0004]© 2009 MedReviews®, LLCLower urinary tract symptomsPhosphodiesteraseCombination therapyBlockers5-reductase inhibitorsAnticholinergicsBenign prostatichyperplasia