Volume 8, Supplement 4Review ArticlesThe Evolution of Alpha-Blockers for the Treatment of Benign Prostatic HyperplasiaAdvances in Alpha-Blocker Therapy in the Management of Urological DisordersHerbert LeporAlpha-blockers have been evaluated for the treatment of benign prostatic hyperplasia (BPH) for 30 years, from early trials with the nonselective a-inhibitor phenoxybenzamine to short-acting (prazosin) then long-acting (terazosin, doxazosin, tamsulosin, alfuzosin) selective a1-antagonists. All of the a-blockers evaluated have demonstrated comparable effectiveness, and the evolution of a-blocker therapy for BPH has therefore focused primarily on improving convenience and tolerability. Although all of the long-acting a1-blockers are well tolerated, only tamsulosin and alfuzosin SR are administered without the requirement for dose titration. Alfuzosin has the additional advantage over tamsulosin of a lower incidence of ejaculatory dysfunction. Studies of subtype-selective a1-antagonists have not demonstrated superior efficacy or improved tolerability over the existing long-acting a1-blockers. [Rev Urol. 2006;8(suppl 4):S3-S9]Benign prostatic hyperplasiaBlockersLower urinary