Aim: The aim of this study is to review the literature regarding the medical management of benign prostatic hyperplasia (BPH), with emphasis on the current mechanistic insights and drugs, so as to provide an update and present recent data to the urologists, surgeons, and clinicians involved in managing the BPH disease.Methods: The National Library of Medicine and PubMed were searched for major published data and trials on the medical management of BPH using the key words benign prostatic hyperplasia, medical management, lower urinary tract symptoms (LUTS), α-blockers, 5-α reductase inhibitors, phytotherapy, and evidence-based medicine. Important landmark trials published in the last 15 years were analysed and tracked for recent changes, newer drugs, and medical therapies currently being used to manage BPH.Results: Major randomised, placebo-controlled landmark trials involving the three major prescriptions, namely α-adrenergic blockers, 5-α reductase inhibitors, and phytotherapeutic agents, were reviewed and discussed.Conclusions: Medical management of LUTS due to BPH is undoubtedly the first choice of BPH therapy, and it has drastically reduced the number of patients that were initially treated by surgery. Combination drug therapy is currently the most efficacious means to prevent BPH progression in terms of patient quality of life and morbidity. Successful medical management of BPH needs an integrated approach tailored to the patient?s symptoms so as to achieve a durable and sustained realistic goal.Key words: Benign prostatic hyperplasia, LUTS, α-adrenergic blockers, 5-α-reductase inhibitors, phytotherapy, evidence-based medicine
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