This combination seems to be more efficacious in terms of several outcome variables in patients whose prostate volume is between 30 ml and 40 ml when treatment is maintained for > 1 yr ; when given for < 1 yr , α1-blockers alone are just as effective .
The combination of α1-blocker/5-ARI shows a slightly increased rate of adverse events .
It remains unknown whether its safety and superiority over either drug as monotherapy are sustained after > 6 yr .
The α1-blocker/muscarinic receptor antagonist ( antimuscarinic ) combination was most frequently assessed as an add-on therapy to already existing α1-blocker therapy .
Inconsistent data derive from heterogeneous study population s and different study design s. Currently , the α1-blocker/antimuscarinic combination appears to be a second-line add-on for patients with insufficient symptom relief after monotherapy .
The combination seems to be safe in men with postvoid residual < 200 ml .
The α1-blocker/phosphodiesterase type 5 inhibitor combination is a new treatment option with only preliminary reports .
CONCLUSIONS An α1-blocker/5-ARI combination is beneficial for patients whose prostate volume is between 30 ml and 40 ml when medical treatment is intended for > 1 yr .
Based on short-term follow-up studies , add-on of antimuscarinics to α1-blockers is an option when postvoid residual is < 200 ml
BACKGROUND Several drugs are approved for the treatment of lower urinary tract symptoms ( LUTS ) in men , but these are mostly used by clinicians as monotherapies .
The combination of different compounds , each of which targets a different aspect of LUTS , seems appealing .
However , only few clinical trials have evaluated the effects of combination therapies .
OBJECTIVE This systematic review analyzes the efficacy and adverse events of combination therapies for male LUTS .
Randomized Controlled Trial to Treat Benign Prostatic Hyperplasia with Overactive Bladder Using an Alpha-blocker Combined with Anticholinergics.
OBJECTIVES TAABO was a r and omized , controlled trial to evaluate the efficacy and safety of combination therapy of tamsulosin ( TAM ) with propiverine ( PROP ) in men with both benign prostatic hyperplasia and overactive bladder . METHODS It enrolled men 50 years or older who had an international prostate symptom score ( IPSS ) of 8 or higher , an urgency item score of 1 or higher , and a quality of life ( QOL ) score of 2 or higher . After 8 weeks of TAM 0.2 mg/day , patients who met the inclusion criteria ( 8 micturitions per 24 h and 1 urgency per 24 h , evaluated by bladder diary ) and were eligible for 12-weeks of continued Treatment II . Five hundred and fifteen patients were enrolled . Thereafter , 214 patients were assigned r and omly to receive either TAM alone ( n = 67 ) , TAM plus PROP 10 mg ( n = 72 ) , or TAM plus PROP 20 mg ( n = 75 ) in Treatment II . The primary efficacy end point was a change in micturitions per 24 h documented in the bladder diary . The change from baseline in urgency episodes per 24 h , IPSS , IPSS/QOL subscore , urinary flow rate and postvoid residual volume were assessed as secondary efficacy measures . RESULTS A total of 141 men ( 47 TAM , 49 TAM plus PROP 10 mg , and 45 TAM plus PROP 20 mg patients ) were assessed by week 12 . Compared with the TAM , TAM plus PROP 10 mg patients experienced significantly fewer micturitions ( P = 0.0261 ) , urgencies ( P = 0.0093 ) per 24 h , lower IPSS storage ( P = 0.0465 ) , and IPSS urgency ( P = 0.0252 ) subscores . CONCLUSIONS These results suggest that combining TAM and 10 mg of PROP for 12 weeks provides added benefit for men with both benign prostatic hyperplasia and overactive bladder
This combination seems to be more efficacious in terms of several outcome variables in patients whose prostate volume is between 30 ml and 40 ml when treatment is maintained for > 1 yr ; when given for < 1 yr , α1-blockers alone are just as effective .
The combination of α1-blocker/5-ARI shows a slightly increased rate of adverse events .
It remains unknown whether its safety and superiority over either drug as monotherapy are sustained after > 6 yr .
The α1-blocker/muscarinic receptor antagonist ( antimuscarinic ) combination was most frequently assessed as an add-on therapy to already existing α1-blocker therapy .
Inconsistent data derive from heterogeneous study population s and different study design s. Currently , the α1-blocker/antimuscarinic combination appears to be a second-line add-on for patients with insufficient symptom relief after monotherapy .
The combination seems to be safe in men with postvoid residual < 200 ml .
The α1-blocker/phosphodiesterase type 5 inhibitor combination is a new treatment option with only preliminary reports .
CONCLUSIONS An α1-blocker/5-ARI combination is beneficial for patients whose prostate volume is between 30 ml and 40 ml when medical treatment is intended for > 1 yr .
Based on short-term follow-up studies , add-on of antimuscarinics to α1-blockers is an option when postvoid residual is < 200 ml
BACKGROUND Several drugs are approved for the treatment of lower urinary tract symptoms ( LUTS ) in men , but these are mostly used by clinicians as monotherapies .
The combination of different compounds , each of which targets a different aspect of LUTS , seems appealing .
However , only few clinical trials have evaluated the effects of combination therapies .
OBJECTIVE This systematic review analyzes the efficacy and adverse events of combination therapies for male LUTS .