Lower urinary tract symptoms (LUTS) are frequently encountered in clinical practice, especially in older men. The main focus in the primary treatment of men with complaints of violation of urination should be paid to assessing their severity on the basis of IPSS questionnaire. It is important to identify the predominant symptoms that determine treatment. In the absence of absolute indications for surgical treatment of clinical forms of benign prostatic hyperplasia (BPH), the drug treatment should be used. In cases of the prevalence of obstructive LUTS, first-line treatment is the use of alpha-adrenoblockers. In case of progression of BPH (prostate volume > or = 40 cm3, PSA > 1,5 ng/ml), it is useful to combine the alpha-adrenoblockers with 5alpha-reductase inhibitors. Combined medication in the form of alpha-adrenoblockers and M- cholinergic antagonists is justified in irritative LUTS in men with BPH.
