There is sufficient evidence that alpha blockers and 5 alpha reductase inhibitors are effective to treat moderate symptoms of BPH. Alpha blocker are safe for normotensive and controlled hypertensive elderly patients, with Tamsulosin having least side effects compared to other alpha adrenoceptor blocker. 5alpha reductase inhibitors have minimal sexual related side effect, but is otherwise safe and well tolerated. With respect to cost implications there is sufficient evidence to support medical management of BPH in older patients, since it is only cost effective for a short time horizon. Alpha blocker are more cost effective than alpha reductase inhibitors. There is insufficient evidence to support the effectiveness and safety of phytotherapy.
Medical management is thus recommended for elderly patients with mild to moderate BPH.