Pharmacological Treatment of Benign Prostatic Syndrome with Alpha1-Receptor Blockers: Basics and Clinical Results

The study reviewed the role of the sympathetic nervous system in regulating urethral resistance and evaluated the effectiveness of alpha1-adrenoceptor antagonists (alfuzosin, doxazosin, tamsulosin, terazosin) in treating benign prostatic hyperplasia (BPH). It found that these medications significantly improved lower urinary tract symptoms (20–65%) and urinary flow (1–4.3 ml/s) in patients, regardless of symptom severity, obstruction degree, or prostate size. The study analyzed 39 randomized, placebo-controlled trials with 14,924 patients, concluding that all alpha1-blockers were equally effective, but alfuzosin and tamsulosin had fewer side effects compared to doxazosin and terazosin. The latter two were no longer recommended for hypertension due to cardiovascular risks. Alpha1-blockers were more effective than plant extracts or finasteride, making them the preferred treatment for symptomatic BPH with minimal obstruction.