Alpha adrenoceptor blockade in the treatment of benign prostatic hyperplasia: past, present and future

• Published in: British Journal of Urology Vol. 80; no. 4; pp. 521 - 532
• Main Authors: KIRBY, R.S., POOL, J.L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.10.1997
• Subjects: Adrenergic alpha-Antagonists - adverse effects; Adrenergic alpha-Antagonists - chemistry; Adrenergic alpha-Antagonists - therapeutic use; Blood Pressure - drug effects; Decision Making; Drug Therapy, Combination; Humans; Hypertension - chemically induced; Male; Patient Selection; Prostatic Hyperplasia - drug therapy; Sexual Dysfunction, Physiological - chemically induced
• ISSN: 0007-1331; 1464-410X
• DOI: 10.1046/j.1464-410X.1997.00247.x

The treatment of BPH by alpha blockade is built upon a sound anatomical, physiological and pharmacological rationale. The theory is borne out in clinical practice; alpha adrenoceptor antagonists have been shown in placebo-controlled studies to improve symptoms of BPH and increase urinary flow rate. In hypertensive patients, there is a clinically significant reduction in blood pressure, with little or no effect on the blood pressure of normotensive patients with BPH. The development of selective alpha-1 adrenoceptor antagonists with a gradual onset and long duration of action has improved the tolerability and makes this class of drug a valuable alternative to surgery in many cases. Further refinements in the selectivity of alpha-1 adrenoceptor antagonists may enable even better targeted alpha blockade for BPH in the future by specific antagonism of the alpha-1 A adrenoceptor, although this hypothesis has yet to be confirmed clinically.