With the advent of new treatments for benign prostatic hyperplasia (BPH), the urologist must objectively assess the results of new and traditional therapeutic options. This requires three sets of data - not all of which may be readily available - including a precise knowledge of the natural history of BPH; an objective assessment of the results of surgery, both open and transurethral; and an accurate estimate of objective and subjective results of medical treatment based on randomized studies with a placebo arm. The two types of medical treatment available are hormonal and neuropharmacologic manipulation. Hormonal treatment, using agents such as luteinizing hormone-releasing hormone agonists or anti androgens, reduces the volume of the epithelial component of the prostate, but urodynamic improvement does not always parallel volumetric reduction. Neuropharmacologic treatment using a-blockers alone or in combination with anticholinergic agents has no effect on prostatic volume, but reduces the tone of the muscular component.

Keywords:
Antiandrogens, Neuropharmacology, Acute retention, Uroflowmetry, Benign prostatic hyperplasia
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1991
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