Four alpha 1-adrenoceptor antagonists are currently available for the medical treatment of lower urinary tract symptoms suggestive of benign prostatic obstruction in Germany: alfuzosin, doxazosin, tamsulosin, and terazosin. Indirect comparison based on randomized, placebo-controlled trials as well as several direct comparative studies have shown equal efficacy of all four drugs on urinary flow and symptom relief if suggested dosing regimens are applied. A dosing regimen below this recommendation should be restricted to those patients who have a proven satisfactory response to a lower dose.