A 68-year-old male presents with worsening urinary hesitancy, a weak stream, and nocturia (waking up 3-4 times per night to urinate) for the past 6 months. Digital rectal exam reveals a symmetrically enlarged, smooth, and firm prostate. Urinalysis is normal, and PSA is 2.5 ng/mL. What is the most appropriate initial medical therapy?
✓ Correct Answer: Option B
This patient has benign prostatic hyperplasia (BPH). Alpha-1 adrenergic blockers like tamsulosin are first-line agents for symptomatic relief, as they relax smooth muscle in the prostate and bladder neck, improving urine flow. Finasteride reduces prostate size but takes longer to act.