Prostatic and extraprostatic alpha-adrenoceptors--contributions to the lower urinary tract symptoms in benign prostatic hyperplasia.

The beneficial effects of alpha-adrenoceptor antagonists on lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH), and the lack of correlation between LUTS on the one hand and prostatic enlargement and/or outflow obstruction on the other, have focused interest on the role of extraprostatic alpha-adrenoceptors in the pathogenesis of LUTS. In addition to their well documented site of action on prostatic and lower urinary tract smooth muscle, alpha-adrenoceptors antagonists may act at the level of the spinal cord, ganglia, and nerve terminals to influence the sympathetic and parasympathetic outflows to the bladder, bladder neck. prostate, and external urethral sphincter. A more complete understanding of the role of alpha-adrenoceptors in the overall autonomic control of the lower urinary tract will be required to design agents that can improve alpha-adrenoceptor antagonist treatment of BPH.