Benign prostatic hyperplasia: use of drug therapy in primary care.

Age and normal male androgenic function are the two most well-established risk factors for benign prostatic hyperplasia. Clinical manifestations of BPH may range from minimally bothersome symptoms to urinary retention and renal failure. Digital rectal examination, serum PSA, urinalysis, serum creatinine, and the AUA symptom score are recommended for the initial evaluation. For mild symptoms, watchful waiting may be all that is needed. For severe symptoms, surgical therapy is the most appropriate option. For men with mild to moderate symptoms, less invasive procedures and several pharmacologic therapies have proved to be effective for treating BPH. The pharmacologic therapies include a 5 alpha-reductase inhibitor (finasteride) and three selective alpha-1 blockers (terazosin, doxasozin, and tamsulosin).