The short-term goal of pharmacotherapy for patients with prostatic hyperplasia (BPH) is to relieve patients’ lower urinary tract symptoms, and the long-term goal is to delay the clinical progression of the disease and prevent comorbidities. The overall goal of drug therapy for BPH is to reduce the side effects of drug therapy while maintaining a high quality of life for patients. 1. α-blockers (1) Mechanism of action and urinary tract selectivity of α-blockers: α-blockers are used to relieve bladder outlet power obstruction by blocking adrenergic receptors distributed on the smooth muscle surface of the prostate and bladder neck and relaxing smooth muscle. (2) Recommendation: alpha-blockers are indicated for patients with BPH who have lower urinary tract symptoms. Tamsulosin, doxazosin, alfuzosin and terazosin are recommended for the pharmacological treatment of BPH. (3) Clinical efficacy: The clinical use of α-blockers for the treatment of lower urinary tract symptoms caused by BPH began in the 1970s. Compared with placebo, various α1-blockers can significantly improve patients’ symptoms, resulting in 30%-40% improvement in symptom scores and 16%-25% increase in maximum urinary flow rate. (4) α-blockers for acute urinary retention: The results of clinical studies showed that patients with acute urinary retention BPH treated with α-blockers had a significantly higher chance of successful catheter removal than placebo treatment. (5) Side effects: Common side effects include dizziness, headache, weakness, sleepiness, postural hypotension, retrograde ejaculation, etc. Postural hypotension is more likely to occur in elderly and hypertensive patients. 2, 5-alpha reductase inhibitors (1) Mechanism of action: 5-alpha reductase inhibitors inhibit the conversion of testosterone to dihydrotestosterone in the body, which in turn reduces the amount of dihydrotestosterone in the prostate, achieving the therapeutic goal of reducing the size of the prostate and improving urination difficulties. (2) Recommendation: Finasteride is indicated for the treatment of patients with BPH who have enlarged prostate volume with lower urinary tract symptoms. (3) Clinical efficacy: The results of several large-scale randomized clinical trials have confirmed the effectiveness of finasteride, reducing prostate volume by 20%-30%, improving patients’ symptom scores by about 15%, increasing urinary flow rates by about 1.3-1.6 ml/s, and reducing the risk of acute urinary retention and the need for surgical intervention in patients with BPH by about 50%. Several studies have shown that finasteride reduces the incidence of hematuria in patients with BPH. Data from studies have shown that finasteride (5 mg/d for more than 4 weeks) applied prior to transurethral resection of the prostate reduces intraoperative bleeding in patients with BPH with large prostate volumes. (4) Side effects: The most common side effects of finasteride include erectile dysfunction, abnormal ejaculation, low libido and others such as gynecomastia and mastalgia. (5) Finasteride affects serum PSA level: Finasteride can reduce serum PSA level. Taking Finasteride 5mg daily for 1 year can reduce PSA level by 50%. For patients who apply finasteride, doubling their serum PSA level does not affect its efficacy in detecting prostate cancer. 3. Combination therapy Combination therapy refers to the combined application of alpha-blockers and 5-alpha reductase inhibitors for the treatment of BPH. (1) Recommendation: Combination therapy is indicated for patients with BPH with enlarged prostate volume and lower urinary tract symptoms. (2) Clinical efficacy: The current study results confirm the long-term efficacy of combination therapy. 4.Chinese medicine and botanical preparations Chinese medicine has made indelible contributions to the development of medicine and health in China as well as the health of the Chinese nation. There are many kinds of herbal medicines applied in the clinical treatment of BPH, please refer to the recommendation of the Society of Traditional Chinese Medicine or Integrative Chinese and Western Medicine to carry out the treatment.