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 .
'Tamsulosin and Darifenacin' Versus 'Tamsulosin Monotherapy' for 'BPH with Accompanying Overactive Bladder'.
PURPOSE To evaluate the efficacy/safety of ' tamsulosin and darifenacin ' ( TD ) vs. ' tamsulosin and placebo ' ( TP ) for patients with symptomatic benign prostrate hyperplasia ( BPH ) with accompanying overactive bladder ( OAB ) symptoms . MATERIAL S AND METHODS This study included symptomatic patients of BPH with one or more of the following OAB symptoms ; micturition frequency > 8 , nocturnal frequency > 2 , urgency > 1 per 24 hour between November 2012 and February 2014 . After protocol approval by ethics committee and obtaining informed consent , patients were r and omly assigned to receive tamsulosin 0.4 mg plus placebo ( TP ) ( n=30 ) or tamsulosin 0.4 mg plus darifenacin 7.5 mg ( TD ) ( n=30 ) for 8 weeks . The mean change from baseline in urinary frequency and incontinence episodes/24 hour ( primary end points ) , and nocturnal frequency ; mean change in PVR and changes in IPSS ( secondary end points ) were compared between groups at 0/eight week using voiding diary and ultrasonography . RESULTS The mean change in frequency , incontinence , nocturnal frequency/24 hour and IPSS ( International prostrate symptom score ) were ( -4.83 vs. -3.93 , p=0.023 ) , ( -1.50 vs. 1.08 , p=0.001 ) , ( -2.20 vs. -1.87 , p<0.001 ) and ( -7.90 vs. -6.27 , p<0.001 ) in the TD/TP group respectively ( significant ) . Apart from some minor side effects ( 12 vs. 9 ) all interventions appeared to be safe and well tolerated . The mean change in the PVR ( Postvoid residual ) was marginal ( + 10.84ml and -16.93 ) and the incidence of urinary retention was 13 % and 3 % in the TD and TP groups respectively ( p=0.35 ) . CONCLUSION Treatment with tamsulosin and darifenacin for 8 weeks is an effective and safe treatment modality in select patients of BPH with accompanying OAB symptoms
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 .