Although additional well design ed , worldwide , placebo-controlled and r and omized studies are necessary to confirm the long-term outcomes of naftopidil pharmacotherapy , current data suggest that naftopidil administration in BPH patients provides comparable improvements in total IPSS , QoL , and urinary symptoms from baseline relative to 0.2 mg/d tamsulosin and 8 mg/d silodosin .
However , improvements in Qmax are generally less with naftopidil than with tamsulosin .
Reported adverse effects related to naftopidil administration are negligible and usually mild .
OBJECTIVES The aim of the study was to systematic ally review the effects of the adrenoreceptor A1D antagonist naftopidil in the management of  lower urinary tract symptoms ( LUTS ) .
Combination treatment with an alpha-blocker plus an anticholinergic for bladder outlet obstruction: a prospective, randomized, controlled study.
PURPOSE We evaluate the effect of tolterodine combined with tamsulosin on quality of life in patients with bladder outlet obstruction and concomitant detrusor instability . MATERIAL S AND METHODS The study included 50 consecutive patients with urodynamically proven mild or moderate bladder outlet obstruction and concomitant detrusor instability . All patients were initially treated with 0.4 mg . tamsulosin orally once a day . A week later the patients were r and omly allocated into group 1 - 25 who continued treatment with tamsulosin only and , group 2 - 25 who also received 2 mg . tolterodine orally twice daily . Reevaluation with a quality of life question naire and urodynamic study was performed after 3 months . RESULTS Two patients from group 2 stopped tolterodine while 1 patient from each group stopped tamsulosin because of hypotension . Analysis revealed statistically significant improvement in quality of life scores only in group 2 patients ( mean score 525.0 and 628.4 before and after treatment , respectively , 2-sided t test p = 0.0003 ) . A significant difference was noted in both groups after treatment for maximum flow rate and volume at first contraction . Additionally , in group 2 , a statistically significant difference was observed for maximum detrusor pressure and maximum unstable contraction pressure after treatment . CONCLUSIONS Combination treatment with an alpha-blocker ( tamsulosin ) plus an anticholinergic ( tolterodine ) improves quality of life in patients with bladder outlet obstruction and concomitant detrusor instability . Interestingly , no acute urinary retention was observed and tolterodine did not affect the quality of urine flow or residual urine volume . The proposed combination appears to be an effective and relatively safe treatment option in patients with bladder outlet obstruction and detrusor instability
Although additional well design ed , worldwide , placebo-controlled and r and omized studies are necessary to confirm the long-term outcomes of naftopidil pharmacotherapy , current data suggest that naftopidil administration in BPH patients provides comparable improvements in total IPSS , QoL , and urinary symptoms from baseline relative to 0.2 mg/d tamsulosin and 8 mg/d silodosin .
However , improvements in Qmax are generally less with naftopidil than with tamsulosin .
Reported adverse effects related to naftopidil administration are negligible and usually mild .
OBJECTIVES The aim of the study was to systematic ally review the effects of the adrenoreceptor A1D antagonist naftopidil in the management of  lower urinary tract symptoms ( LUTS ) .