Which class of medication is often first-line to relieve BPH-related lower urinary tract symptoms by relaxing smooth muscle in the bladder neck and prostate?

• A. Beta-adrenergic antagonists
• B. ACE inhibitors
• C. Alpha-adrenergic antagonists (alpha blockers)
• D. Diuretics

Answer: (C)

Alpha-adrenergic antagonists (alpha blockers) are often the first choice for relieving BPH-related lower urinary tract symptoms because they directly relax smooth muscle in the bladder neck and prostate. By blocking alpha-1 receptors in these tissues, the outlet becomes gentler to urine flow, reducing resistance and improving symptoms such as weak stream, hesitancy, and nocturia. This produces relatively rapid improvement, making them a common initial therapy for bothersome LUTS due to BPH. Side effects to plan for include dizziness and orthostatic hypotension, especially with the first dose, and some men notice changes in ejaculation. If the prostate is notably enlarged, a clinician may add a longer-term treatment like a 5-alpha-reductase inhibitor, which helps shrink the gland over time. Other drug classes don’t target the outlet to relieve obstruction in this way, which is why this option best fits the question.