α-Blockers vs. α-Blockers plus Anticholinergics for Benign Prostatic Hyperplasia

In patients with benign prostatic hyperplasia (BPH), α-blockers such as tamsulosin and doxazosin work primarily by relieving obstructive symptoms (e.g., incomplete emptying, weak stream). However, many BPH patients also have “storage symptoms” (e.g., frequency, urgency, nocturia) for which anticholinergic drugs such as oxybutynin and tolterodine might be helpful. Researchers conducted this meta-analysis of seven studies (3600 BPH patients) in which α-blocker monotherapy was compared with combination therapy (α-blocker plus anticholinergic agent).

Combination therapy, compared with monotherapy, improved symptoms on a storage subscore of the widely used International Prostate Symptom Score (I-PSS); although the difference was statistically sig…