Abstract
Importance of the field: Benign prostatic enlargement (BPE) leading to benign prostatic obstruction (BPO) affects an increasing number of men as they grow older. They can affect quality of life and cause lower urinary tract symptoms (LUTS) including urinary retention. The currently available pharmacotherapies are alpha-blockers and 5-alpha reductase inhibitors which may be effective but can have adverse effects and long-term compliance problems. Therefore, it is important to find new medical treatments for LUTS/BPO and this review aims to identify the potential future drugs undergoing clinical trials in this field. Areas covered in this review: Articles were identified by means of a computerized Google, PubMed and Cochrane Library search over the last 10 years (using the following keywords: benign prostate hyperplasia, enlargement and obstruction) and a search of the PharmaProjects database. What the reader will gain: An insight into the currently available and future potential treatments for benign prostatic obstruction. Take home message: The exact etiology of benign prostatic hyperplasia (BPH) and its consequences, BPE and BPO, are not known; however, ageing and functioning testes have been implicated. Several classes of drugs are currently undergoing clinical trials such as phosphodiesterase inhibitors and leutenizing hormone-releasing hormone antagonists. Others include phytoestrogens, progestogens, NX1207 and PRX302. Some of these work by affecting testosterone level and, therefore, on the static component of BPO, while it is not known how the rest work. Until the exact etiology of BPH/BPE/BPO is known, we are unlikely to have the cure for this ageing male phenomenon.