How Effective Is Combining an α-Blocker and an Antimuscarinic Drug for Patients with Benign Prostatic Hyperplasia?

Alpha-blockers such as tamsulosin are standard first-line drugs for obstructive voiding symptoms related to benign prostatic hyperplasia (BPH). However, many men with BPH also have “storage symptoms” (e.g., urgency and frequency) attributed to detrusor muscle overactivity. To manage those symptoms, clinicians sometimes add antimuscarinic agents such as oxybutynin or tolterodine.

To examine whether combined therapy — an α-blocker plus an antimuscarinic drug — is substantially better than α-blocker monotherapy for men with both obstructive and storage symptoms, researchers conducted this meta-analysis. Twelve placebo-controlled randomized trials (with ≈4600 patients) were identified; most trials were comparisons between tamsulosin alone and ta…