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 Tadalafil effect on lower urinary tract symptoms of benign prostatic hyperplasia in patients treated with standard medication.
OBJECTIVES To evaluate safety and efficacy of tadalafil on  lower urinary tract symptoms ( LUTS ) suggestive of benign prostatic hyperplasia ( BPH ) in patients treated with st and ard medication . MATERIAL S AND METHODS In this case-controlled r and omized clinical trial , from November 2008 to August 2009 , 132 patients with obstructive and irritative urinary tract symptoms due to BPH , IPSS ≥ 8 , no indication for surgical intervention and that reached plateau levels of response to treatment were selected . These patients were r and omly allocated in two groups ( each containing 66 patients ) . The treatment group received st and ard treatment of BPH and tadalafil ( 10 mg nightly ) ; the placebo group received only st and ard treatment of BPH . IPSS , maximum urinary flow rate ( Qmax ) and quality of life were assessed before and after a 3-month period of study . RESULTS Before treatment , mean IPSS , Qmax and quality of life values in the treatment and placebo groups were 13.06 ± 4.37 and 13.66 ± 4.25 , 8.92 ± 2.96 mL/s and 9.09 ± 2.91 mL/s , 2.93 ± 0.86 and 2.66 ± 0.78 , respectively . After treatment , mean IPSS , Qmax , and quality of life values in treatment group were 7.66 ± 3.99 , 9.99 ± 4.76 mL/s and 1.80 ± 0.98 , respectively . These findings were compared to corresponding values of the placebo group ( 11.37 ± 3.64 , 8.73 ± 2.22 mL/s and 2.19 ± 0.53 , respectively ) : IPSS and quality of life were significantly different but Qmax did n't show a significant change . CONCLUSIONS Tadalafil  improves quality of life and urinary symptoms in patients with LUTS suggestive of BPH , but does n't have any significant effect on Qmax . Therefore , this drug may be effectively used in combination with st and ard medical therapies for BPH
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 .