Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) Part II: Medical Management.

PURPOSE: This Guideline covers the treatment of lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The summary presented herein represents Part II of the three-part series dedicated to Management of LUTS attributed to BPH. Please refer to Parts I and III for additional information on this topic.

MATERIALS AND

METHODS

The systematic review that informs this Guideline was based on searches in Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews through January 2025. Update searches were conducted on December 15, 2025. Literature searches were limited to studies of medical therapies published since 2009 and surgical studies published since 2014. The searches were supplemented by reviewing electronic database reference lists of relevant articles. Criteria for inclusion and exclusion of studies were based on the Key Questions and the populations, interventions, comparators, outcomes, timing, types of studies and settings (PICOTS) of interest developed by the Panel.

RESULTS

The medical management of LUTS/BPH is considered a part of non-procedural management, and the Guideline statements herein address this topic in addition to behavioral/lifestyle interventions for patients with LUTS/BPH. Specific risks are further elucidated for unique patient populations such as those undergoing ophthalmologic surgery.

CONCLUSIONS

Non-procedural interventions should be provided within the shared decision-making context and take into account efficacy as well as durability and adverse events. It is also important to disclose unique actions of medication to relevant patient populations such as patients on active surveillance for prostate cancer.