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 silodosin in comparison to tamsulosin in benign prostatic hyperplasia: A randomized controlled trial
Objectives : Benign prostatic hyperplasia ( BPH ) is the most common cause of lower urinary tract symptoms in elderly men .  Selective alfa1-adrenergic antagonists are now first-line drugs in the medical management of BPH . We conducted a single-blind , parallel group , r and omized , controlled trial to compare the effectiveness and safety of the new alfa1-blocker silodosin versus the established drug tamsulosin in symptomatic BPH . Material s and Methods : Ambulatory male BPH patients , aged above 50 years , were recruited on the basis of International Prostate Symptom Score ( IPSS ) . Subjects were r and omized in 1:1 ratio to receive either tamsulosin 0.4 mg controlled release or silodosin 8 mg once daily after dinner for 12 weeks . Primary outcome measure was reduction in IPSS . Proportion of subjects who achieved IPSS < 8 , change in prostate size as assessed by ultrasonography and changes in peak urine flow rate and allied uroflowmetry parameters , were secondary effectiveness variables . Treatment emergent adverse events were recorded . Results : Data of 53 subjects – 26 on silodosin and 27 on tamsulosin were analyzed . Final IPSS at 12-week was significantly less than baseline for both groups . However , groups remained comparable in terms of IPSS at all visits . There was a significant impact on sexual function ( assessed by IPSS sexual function score ) in silodosin arm compared with tamsulosin . Prostate size and uroflowmetry parameters did not change . Both treatments were well-tolerated . Retro grade ejaculation was encountered only with silodosin and postural hypotension only with tamsulosin . Conclusions : Silodosin is comparable to tamsulosin in the treatment of BPH in Indian men . However , retro grade ejaculation may be troublesome for sexually active patients
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 .