Non-surgical management of BPH: An updated review of current literature and state of the art on natural compounds and medical therapy.

Introduction: Benign prostatic hyperplasia (BPH) is a common urological disease that is strongly associated with the aging process and can lead to lower urinary tract symptoms (LUTS). LUTS due to BPH can signifi cantly affect the quality of life of many patients. Among the treatments available for BPH to improve symptoms and func tional outcomes, drug therapy and surgical therapy are the options of choice. However, for most patients with symptomatic BPH, medical management remains the cornerstone of treat ment. Pharmacologic interventions are often preferred as a first approach, being less invasive compared to surgery. Although the medical treatment of BPH is currently defined by the algorithms of international guidelines, the need for a more personalized approach is increasingly recognized given the wide and hetero geneous range of therapeutic options available. Materials and methods: A review of medical therapy for BPH was conducted using relevant articles in PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. In this review, all drug treatments currently available on the interna tional market whose efficacy is scientifically proven are reviewed and described (phytotherapy, alpha-blockers, mus carinic receptor antagonists, 5-alpha-reductase inhibitors, combination therapies, etc.). Results: A total of 17 randomized clinical trials were selected for review. Further 75 studies were included for analysis and discussion. Conclusions: As the treatment landscape continues to evolve, tailoring therapy to individual patient needs and preferences is likely to become increasingly important to ensure that treatment strategies are both effective and meet patient expectations.