Benign prostatic hyperplasia (BPH), frequently affecting elderly men, is associated with bothersome lower urinary tract symptoms (LUTS) and represents a growing nosological entity in terms of health care costs and morbidity. Current pharmacological treatments include 5-α reductase inhibitors, α-adrenergic antagonists, and non-steroidal anti-inflammatory drugs. However, a distinct proportion of patients with LUTS do not respond to treatment and a fraction of responders is penalized by the occurrence of side effects as loss of libido, sexual dysfunction, hypotension, and others. As a consequence, unresponsive patients, and those becoming resistant to treatment will become candidates for surgical intervention to reduce LUTS severity.