Manage benign prostatic hyperplasia-associated lower urinary tract symptoms using a personalized approach

Lower urinary tract symptoms (LUTS; i.e. storage, voiding and post-micturition symptoms) are a frequent complaint in adult men and strongly associated with aging. A common cause is benign prostatic obstruction, which typically results from benign prostatic hyperplasia (BPH) progressing through benign prostatic enlargement. Treatment of BPH-associated LUTS can be conservative, pharmacological or surgical, and aims to reduce the obstruction and alleviate LUTS. A personalized approach (considering, among other factors, symptom severity, prostate size, comorbidities and patient preference) is recommended. In patients with mixed symptom profiles or those who have insufficiently responded to pharmacological monotherapy, the use of pharmacological combination therapy (e.g. α1-adrenoceptor antagonist plus 5-alpha reductase inhibitor) may be warranted. Tolerability data for most pharmacological combination therapies are limited.