Tamsulosin and silodosin are both considered uroselective with high affinity for alpha-1A receptor subtype. Alfuzosin is non-selective, but functionally uroselective as it concentrates in prostatic tissue more than plasma. In patients with LUTS/BPH, uroselective ABs, tamsulosin, alfuzosin, and silodosin result in improved symptom scores and therefore should be recommended as a treatment option. These agents typically reduce IPSS by 30-40% and increase Qmax by 20-25%.140 A systematic review141 and multiple RCTs142-144 included within this Guideline’s systematic review reported an improvement in IPSS of two to four points over placebo regardless of the uroselective agent used. Therefore, ABs are usually considered the first-line treatment for LUTS/BPH because of their rapid onset, good efficacy, and low incidence of severe adverse events. However, ABs do not prevent the occurrence of urinary retention or progression to the need of surgery. Older ABs, doxazosin and terazosin, have been used for the management of LUTS/BPH, but due to higher rates of orthostatic hypotension and dizziness,145 these are not considered ideal because of the readily available uroselective drugs. However, if patients have been managed well with non-uroselective ABs without side effects, the Panel found no reason to discontinue treatment and start uroselective agents. Non-uroselective ABs, therefore, are useful for LUTS/BPH and can be continued but they are generally not the first choice for AB-naïve patients due to the need for titration and possible side-effects. It is not advisable to add uroselective ABs for patients who are on ABs for other reasons (e.g., hypertension). Comparative studies between the uroselective ABs were sparse but did not show a consistent comparative difference in terms of IPSS improvement. These studies included silodosin versus alfuzosin,146, 147 silodosin versus tamsulosin,141, 146-148 and alfuzosin versus tamsulosin.146, 147 There were, however, relatively consistent differences in side effects between agents in the comparative trials. Ultimately, the use of specific uroselective ABs is not guided by differences in efficacy but more so by differences in side-effect profiles.