Among the most clinically and epidemiologically important urological conditions are benign obstructive prostatic hiperplasia (BPH), erectile dysfunction (ED) and urinary incontinence (UI).

According to the demographic burden of urological diseases in America, prostatic hiperplasia had an increase in incidence from 10,116 per 100,000 in 1994 to 14,473 per 100,000 in 2000 at the outpatient level. However, emergency department or hospitalization visits decreased from 330 per 100,000 in 1994 to 218 per 100,000 in 2000. This change in the epidemiological panorama is mainly determined by two types of treatment that emerged at the end of the 90´s of the last century.

Alpha-5-reductase inhibitors and alpha-inhibitors accounted for more than 31% of medical prescriptions in the same period of time, which shows how a new therapeutic intervention can modify the epidemiological behavior of a disease in terms of patient care requirements. In other words, from the need for an emergency department, patients are treated only in outpatient clinics. The two treatments most heavily involved are finasteride and tamsulosin. The former accounted for about 8% of all urological prescriptions and the latter for more than 23%.

Los dos tratamientos más fuertemente involucrados son la finasterida y la tamsulosina. Del primero se contabilizaron cerca del 8% de todas las prescripciones urológicas y de la segunda más de 23%.

The widespread use of these pharmacological agents is supported by extensive clinical and medical literature on prostatic conditions, the study of lower urinary symptoms and disease progression, where it was shown that combination therapy (a-blocker and 5-alpha reductase inhibitor) was almost twice as effective as monotherapy in decreasing the risk of progression or worsening of symptomatology (66% risk reduction for the combination, 39% for doxazosin and 34% for finasteride). Although the frequency of the disease is increasing corresponding to the increase in the longevity of the male population, the way in which these alterations are treated has become at least favorable, moving from hospital or urgency services to being treated only at home, in addition to the decrease in the need for surgery in some groups of patients.

An example of this is that minimally invasive prostate surgery increased from 264 to 357 per 100,000 inhabitants between 1998 and 2000 and the dramatic drop in transurethral prostate resection as a conventional treatment.