With tamsulosin, there’s an increased risk of falls which is the leading cause of injury for adults ages 65 years and older. And while there’s more research that needs to be done, studies have shown a link between 5-ARIs, alpha-blockers, and anticholinergics potentially causing significant neurocognitive and psychiatric side effects, including dementia and depression.

Patients prescribed these medications need to take them daily for the rest of their lives and frequently have multiple prescriptions to treat BPH symptoms, leading to stacking of numerous medications. Potential negative impacts of long-term BPH medication use also include increases in blood glucose, glycated hemoglobin, total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels, liver enzymes and reduced testosterone, according to a 2017 retrospective study of 460 men comparing long-term dutasteride to tamsulosin use. While no changes were seen in the cohort of men taking tamsulosin, the study suggests that dutasteride may cause a negative imbalance of metabolic function.


Historically, urologists have downplayed BPH medication side effects, but the reality is that men care about them and it’s just one of the reasons why compliance with these medications is so low. It’s important for physicians to help patients understand all of the potential long-term risks prior to prescribing them.

Improved options
Urologists and patients are taking note that today there are safe and effective, minimally invasive technologies that don’t cause the same side effects as medications, don’t impact men’s sexual function and address the root issue of bladder obstruction.

While the transurethral resection of the prostate (TURP) surgical procedure has been the gold standard in BPH treatments, it is an invasive surgery and there are significant risks involved including sexual side effects, incontinence, bleeding, and a much longer recovery time.

Over the past 10-15 years, we have seen the introduction of a brand new category of BPH treatments called minimally invasive surgical therapies (MISTs). This category was created to provide treatment options with many benefits compared to medication therapy, including one-time treatment versus a lifetime of medications, lower risk for side effects, and improved efficacy because they can actually fix the problem instead of just kicking the can down the road by with medication. MIST options that are cleared by the U.S. Food and Drug Administration to be safe and effective include:

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