Based on improvement of mean International Prostate Symptom Score and quality of life scores , the effectiveness of the newer ABs was not different from the older ABs ( moderate strength of evidence [ SOE ] ) , but had more AEs ( low SOE ) .
Antimuscarinics/AB combination therapy had similar outcomes  as AB monotherapy ( all moderate SOE ) , but often had more AEs .
Phosphodiesterase type-5 inhibitors alone or in combination with ABs had similar or inferior outcomes than ABs alone .
Evidence was insufficient for the beta-3 adrenoceptor agonist .
For all newer agents , the evidence was generally insufficient to assess long-term efficacy , prevention of symptom progression , or AEs .
None of the drugs or drug combinations newly used to treat LUTS attributed to BPH showed outcomes superior to traditional AB treatment .
Given the lack of superior outcomes , the studies ' short time-horizon , and less assurance of their safety , their current value in treating LUTS attributable to BPH appears low .
We found none of the new drugs to be better but there was more concern about side effects
CONTEXT Alpha-blockers ( ABs ) and 5-alpha reductase inhibitors have an established role in treating male lower urinary tract symptoms ( LUTS ) attributed to benign prostatic hyperplasia ( BPH ) .
Recently , newer drugs have shown promise for this indication .
OBJECTIVE To assess the comparative effectiveness and adverse effects ( AEs ) of newer drugs to treat LUTS attributed to BPH through a systematic review and meta- analysis .
PATIENT SUMMARY In this paper , we review ed the evidence of newer drugs to treat men with urinary problems attributable to an enlarged prostate .
Evaluation of the effect of sildenafil and/or doxazosin on Benign prostatic hyperplasia–related lower urinary tract symptoms and erectile dysfunction
Purpose : To verify the association between lower urinary tract symptoms ( LUTS ) and erectile dysfunction ( ED ) and evaluate the influence of sildenafil and doxazosin either as single agents or combined on both symptoms . Material and Methods : A prospect i ve r and omized study including 150 patients presented with LUTS caused by BPH in association with clinical ly diagnosed ED , with age equal or more than 45 years from April 2010 to April 20011 . They were categorized into three comparative groups each one containing 50 patients . These groups were comparable regarding pretreatment international prostate symptoms score ( IPSS ) and international index of erectile function ( IIEF ) . The patients of the first group were given sildenafil 50 mg as monotherapy , those of the second group were given doxazosin 2 mg and those of the third group were given combination of both drugs for 4 months for each group . The main post-treatment parameters for assessment and comparison include assessment of patient 's symptoms by repeated IPS S and IIEF , uroflowmetry and assessment of PVR . The statistics was done by use of the Qui -- square test . Results : Pre-treatment parameters were assessed and compared between the three groups . After 4 months of treatment , the comparative parameters were applied to all groups and the differences were measured post-treatment regarding IPSS , erectile function score , uroflowmetry , and post-void residual ( PVR ) urine . Sildenafil alone caused mild improvement in IPSS , more improvement in IIEF score , and little effect on flow rate and PVR urine .  Doxazosin alone caused more improvement in IPSS , flow rate and PVR urine and less improvement in IIEF score . A combination of both sildenafil and doxazosin caused more improvement in all of the comparative parameters than when each drug was given alone . Conclusions : There is a strong relationship between LUTS and ED . Doxazosin or sidenafil as a single drug could be used in treating mild or mild to moderate symptoms but more severe symptoms may usually need a combination of both drugs
Based on improvement of mean International Prostate Symptom Score and quality of life scores , the effectiveness of the newer ABs was not different from the older ABs ( moderate strength of evidence [ SOE ] ) , but had more AEs ( low SOE ) .
Antimuscarinics/AB combination therapy had similar outcomes  as AB monotherapy ( all moderate SOE ) , but often had more AEs .
Phosphodiesterase type-5 inhibitors alone or in combination with ABs had similar or inferior outcomes than ABs alone .
Evidence was insufficient for the beta-3 adrenoceptor agonist .
For all newer agents , the evidence was generally insufficient to assess long-term efficacy , prevention of symptom progression , or AEs .
None of the drugs or drug combinations newly used to treat LUTS attributed to BPH showed outcomes superior to traditional AB treatment .
Given the lack of superior outcomes , the studies ' short time-horizon , and less assurance of their safety , their current value in treating LUTS attributable to BPH appears low .
We found none of the new drugs to be better but there was more concern about side effects
CONTEXT Alpha-blockers ( ABs ) and 5-alpha reductase inhibitors have an established role in treating male lower urinary tract symptoms ( LUTS ) attributed to benign prostatic hyperplasia ( BPH ) .
Recently , newer drugs have shown promise for this indication .
OBJECTIVE To assess the comparative effectiveness and adverse effects ( AEs ) of newer drugs to treat LUTS attributed to BPH through a systematic review and meta- analysis .
PATIENT SUMMARY In this paper , we review ed the evidence of newer drugs to treat men with urinary problems attributable to an enlarged prostate .