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 .
Comparative efficacy assessment of tamsulosin vs. tamsulosin plus tadalafil in the treatment of LUTS/BPH. Pilot study.
INTRODUCTION The high incidence of erectile dysfunction ( ED ) and lower urinary tract symptoms ( LUTS ) in aging men and the same pathophysiology make probable to treat both disorders with the same treatment . Numerous authors evaluated the actions of PDE5i in improving the LUTS/(benign prostate hyperplasia ) BPH . AIM To assess the efficacy and safety of tamsulosin 0.4 mg/day vs. tamsulosin 0.4 mg/day plus tadalafil 20 mg/day in patients with LUTS in a crossover design study . MAIN OUTCOMES MEASURES International Prostate Symptoms Score ( IPSS ) , IPSS Quality of Life ( IPSS-QOL ) , maximum flow rate ( Qmax ) , post-void residual volume ( PVR ) , International Index of Erectile Function-Erectile Function Domain ( IIEF-EF ) , Global Assessment Quality ( GAQ ) . For the statistical analysis , a Tukey-Kramer multicomparison test was used . METHODS A r and omized , double-blind , crossover study was conducted from September 2007 to February 2008 in one center . Thirty men , older than 50 years old , with a history of LUTS/BPH of at least 6 months , were r and omized into two groups to receive tamsulosin 0.4 mg/day vs. tamsulosin 0.4 mg/day plus tadalafil 20 mg/day for 45 days , and then switched to the other treatment mode for other 45 days . RESULTS Twenty-seven patients completed the study . Improvements of IPSS score and IPSS-QOL were significant with both treatments but greater with the drug combination . Both regimens similarly improved the Qmax and decreased the PVR volume from baseline ( P < 0.001 ) with no significant differences between tamsulosin alone vs. tamsulosin and tadalafil ( P > 0.05 ) . The IIEF improved with tamsulosin plus tadalafil ( P < 0.001 ) but not with tamsulosin alone ( P > 0.05 ) . The GAQ showed that all patients preferred the combination scheme . Both treatments were well tolerated . CONCLUSION ; Tamsulosin 0.4 mg/day plus tadalafil 20 mg/day was more effective than tamsulosin 0.4 mg/day alone to improve LUTS and erectile dysfunction and was also well tolerated . Large-scale , r and omized , placebo-controlled studies are needed to further assess the long-term safety and effectiveness of these agents in treating LUTS/BPH with or without ED
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 .