We found in total 2,628,170 users of alpha-1 blockers and 464,525 users of alternative BPH therapy—5-alpha reductase inhibitors and phosphodiesterase type 5 inhibitors (5ARI/PDE5)—with diagnosis of BPH, all of whom were included in our propensity score (PS) stratified analyses. This evidence concerns the gene PDE5A and benign prostatic hyperplasia.