Prostate enlarged

Benign Prostatic htpertrophy

• Alpha blockers improve symptoms on average by 2-3 points more than placebo (35 point AUAscale), a difference patients perceive as 'slight benefit'. Alpha blockers do not reduce complications, but increase dizziness, postural hypotension and asthenia (ARI 3-8%, NNH 13-33).

• 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. This prevents an assessment of the overall clinical impact of drug treatment.