title: Latest pharmacotherapy options for benign prostatic hyperplasia.
abstract: BACKGROUND
  Benign prostatic hyperplasia (BPH) is a very common condition in men over 50 years, often resulting in lower urinary tract symptoms (LUTS). Medical therapy aims at improving quality of life and preventing complications. The range of drugs available to treat LUTS is rapidly expanding.
  
  
  METHODS
  Silodosin is a relatively new α1-adrenoreceptor antagonist that is selective for α1A-adrenergic receptor. While causing smooth muscle relaxation in the lower urinary tract, it minimizes blood pressure-related adverse effects. Tadalafil, a PDEs type 5 inhibitor, is a drug recently approved for the treatment of BPH/LUTS that challenges the standard therapy with α1-blockers, especially in men with concomitant erectile dysfunction (ED). Mirabegron is the first β3-adrenoceptor agonist approved for the treatment of symptoms of overactive bladder. BPH-related detrusor overactivity (DO) may be successfully targeted by mirabegron. Gonadotropin-releasing hormone antagonists, intraprostatic injections with NX-1207 and vitamin D3 receptor analogues exerted beneficial effects on LUTS but need further evaluation in clinical studies.
  
  
  CONCLUSIONS
  Choosing the right treatment should be guided by patients' symptoms, comorbidities and potential side effects of available drugs. Silodosin is a valid option for elderly and for people taking antihypertensive drugs. BPH patients affected by ED can target both conditions with continuous tadalafil therapy. The encouraging data on mirabegron use in BPH-DO have to be further assessed in larger prospective randomized clinical trials.
authors.affiliation: Università Vita-Salute San Raffaele , Milan , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Russo
authors.forename: Giovanni
authors.initials: G
authors.lastname: La Croce
authors.forename: Paolo
authors.initials: P
authors.lastname: Capogrosso
authors.forename: Eugenio
authors.initials: E
authors.lastname: Ventimiglia
authors.forename: Michele
authors.initials: M
authors.lastname: Colicchia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.forename: Rocco
authors.initials: R
authors.lastname: Damiano
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
mesh_terms: D007172:Erectile Dysfunction / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
keywords: benign prostatic hyperplasia; bladder outlet obstruction; lower urinary tract symptom; medical therapy