Can Long-term LUTS/BPH Pharmacological Treatment Alter the Outcomes of Surgical Intervention?

Purpose of Review We have reviewed the available evidence on the impact of long-term pharmacological treatment of lower urinary tract symptoms on the outcomes of benign prostatic hyperplasia surgery. Evidence Acquisition A systematic literature search from January 1990 to May 2017 was performed. Only references in the English language and peer-reviewed manuscripts were considered. Recent Findings Over time, the ever-increasing use of long-term pharmaceutical treatments has considerably reduced the rate of BPH surgery in most countries. In addition, patients undergoing surgery are now generally older, more fragile and with larger prostates. Nevertheless, progress in the surgical field may have compensated for this critical picture and no pejorative trend has been recorded in peri-and post-operative complications and functional outcomes. Summary The question whether long-term pharmacological treatment has altered the outcomes of surgical interventions of BPH remains with no clear answer. The call for randomized studies of long-term pharmacological vs surgical treatment of lower urinary tract symptoms due to BPH pharmacological treatment remains valid.