Benign Prostatic Hypertrophy

Conclusion

Alpha blockers improve symptoms on average by 2-3 points more than placebo - a difference patients perceive as 'slight benefit'. Alpha blockers increase dizziness, postural hypotension and asthenia.)

5-a-reductase inhibitors reduce acute urinary retention (ARR 2%, NNT 50), and BPH surgery (ARR 2-3%, NNT 33-50), but impair sexual function (ARI 3%, NNH 33).

There is insufficient evidence that combining the two drug classes provides additional benefit.

Most BPH trials do not report total serious adverse events and mortality.

Saw palmetto

A new 1-year RCT comparing standardized doses (160 mg BID) with placebo showed no differences in symptom scores, urinary flow rates, quality of life measures, adverse effects or SAEs.35