Alpha Blocker Monotherapy Versus Alpha Blocker with Anticholinergics for Men with Residual Overactive Bladder Symptoms Secondary to Prostate Disease: A Systematic Review

Alpha Blocker Monotherapy Versus Alpha Blocker with Anticholinergics for Men with Residual Overactive Bladder Symptoms Secondary to Prostate Disease: A Systematic Review
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Title:Alpha Blocker Monotherapy Versus Alpha Blocker with Anticholinergics for Men with Residual Overactive Bladder Symptoms Secondary to Prostate Disease: A Systematic Review
Author/Abstract:
Alpha Blocker Monotherapy Versus Alpha Blocker with Anticholinergics for Men with Residual Overactive Bladder Symptoms Secondary to Prostate Disease: A Systematic Review

Robert C. Bravo, MD1 and Marie Carmela M. Lapitan, MD1,2,3

1Division of Urology, Department of Surgery, University of the Philippines-Philippine General Hospital
2Department of Surgery, College of Medicine, University of the Philippines Manila,
3National Institutes of Health, University of the Philippines Manila

Summary of Findings:
- Treatment with alpha blockers alone does not always control lower urinary tract symptoms
associated with benign prostatic hyperplasia (BPH). The addition of anticholinergics, which act
by preventing unstable detrusor contractions, may improve overactive bladder(OAB) symptoms.
- Seven randomized controlled trials compared the outcomes of treatment with alpha blockers
alone with a combination of alpha blockers with anticholinergics for menwith OAB symptoms
associated with BPH.
- Compared with alphablocker monotherapy, meta-analysis of the trial data suggested that
combination treatment resulted in :
o A statistically significant improvement in lower urinary tract symptoms as assessed by the
International Prostate Symptoms Score and the OAB Symptom Score.
o A statistically significant improvement in frequency, nocturia and urgency symptoms.
o No significant difference in voiding symptoms [post void residual volume, maximum flow
rate (Qmax), patients perception of bladder condition].
o A statistically significant higher risk for adverse events, most common of which was dry
mouth.
- Cumulative analysis showed a urinary retention rate}�%�
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