OBJECTIVES: Assess the impact of the treatment of urinary disorders of the lower urinary tract (LUT) suggestive of benign prostatic hypertrophy (BPH) using medical treatment under actual conditions of use. METHODS: A pragmatic cohort of 420 patients (France, Italy, and Portugal) treated medically, was followed up for 6 months, using 3 questionnaires: IPSS, MSF4 and SF12. RESULTS: 366 patients under medical treatment were assessed. 267 patients were treated with phytotherapy, versus 80 patients on “other treatments”. At inclusion, the patients treated with Serenoa repens versus "other treatments” were different on the following characteristics: Age (p=0.0047), time since diagnosis (p=0.006), country (p<0.0001), IPSS score (p=0.0087), physical dimension of the SF12 (p=0.0071). The “change from baseline” for the scores of the IPSS and SF12 self-assessment questionnaires between the 2 treatment groups was comparable. A generalized linear model adjusted for age, time since diagnosis, country, IPSS score, and the physical dimension of the SF12 score at inclusion was used, making the 2 treatment groups comparable. We observed an improvement in the IPSS score from 6 weeks. We were not able to demonstrate a significant difference between the 2 treatment groups concerning the “change from baseline” of the IPSS score (p=0.7288). The same applies to the analyses at 3 and 6 months where the p-values were 0.2047 and 0.0947 respectively. We did not observe any statistical difference in the scores for the 2 dimensions of the SF12 between the 2 treatment groups. CONCLUSIONS: We observed an improvement in the IPSS and SF12 scores from 6 weeks. This improvement was not significantly different between the 2 treatment groups. Under actual conditions of use, the various medical treatments gave similar improvements.