title: [Benign prostatic hyperplasia medical treatment: systematic review of the literature by the CTMH/AFU].
abstract: OBJECTIVE
  The medical treatment of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS-BPH) has dramatically evolved within the last years: new drugs have been commercialized and others that used to be contra-indicated may now be prescribed. Our objective was to provide with an updated review of the scientific literature on the medical treatment of LUTS-BPH.
  
  
  METHODS
  A systematic review of the most recent scientific literature was performed. The query was addressed to the PubMed database using the following keywords: "benign prostatic hyperplasia" and "medical treatment". A very large amount of publications, from year 1990 until 2011, were reviewed to select the publications with level of evidence 1 and 2. These publications were analysed and the 30 most relevant were selected to serve as references for this article.
  
  
  RESULTS
  There are many randomized clinical trials in the field of LUTS-BPH medical treatment. Recently, anti-muscarinic agents have been assessed and have proven their efficacy and tolerance as long as the storage symptoms are predominant over the voiding symptoms. Combination therapies using alpha-blockers and 5-alpha reductase (5-ARI) inhibitors, but also anti-muscarinic agents and PDEF-5 inhibitors may also be prescribed depending on the patient' complaint.
  
  
  CONCLUSIONS
  The publication of recent randomized clinical trials allows the urologists to use new drugs and new combination therapies in the medical treatment of LUTS-BPH. In 2011, the medical treatment decision-making may better integrate the patient' complaint and medical history.
authors.affiliation: Service d'urologie, CHU de Bordeaux, université Bordeaux-Segalen, place Amélie-Raba-Léon, 33000 Bordeaux, France. gregoire.robert@chu-bordeaux.fr
authors.forename: G
authors.initials: G
authors.lastname: Robert
authors.forename: A
authors.initials: A
authors.lastname: Descazeaud
authors.forename: N Barry
authors.initials: NB
authors.lastname: Delongchamps
authors.forename: J-N
authors.initials: JN
authors.lastname: Cornu
authors.forename: A R
authors.initials: AR
authors.lastname: Azzouzi
authors.forename: O
authors.initials: O
authors.lastname: Haillot
authors.forename: M
authors.initials: M
authors.lastname: Devonec
authors.forename: M
authors.initials: M
authors.lastname: Fourmarier
authors.forename: C
authors.initials: C
authors.lastname: Ballereau
authors.forename: B
authors.initials: B
authors.lastname: Lukacs
authors.forename: O
authors.initials: O
authors.lastname: Dumonceau
authors.forename: C
authors.initials: C
authors.lastname: Saussine
authors.forename: A
authors.initials: A
authors.lastname: de la Taille
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D008517:Phytotherapy; D011470:Prostatic Hyperplasia / Q000628:therapy*
chemical_list: D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists; D018680:Cholinergic Antagonists; D010726:Phosphodiesterase Inhibitors