Safety and efficacy of anticholinergic and α-blocker combination therapy in treatment of benign prostatic hyperplasia

Although voiding symptoms are classically related to BPH, as many as 50% of patients can experience irritative symptoms. We compared safety and efficacy of combination therapy using α-blocker with anticholinergic agents with tamsulosin alone. We compared anticholingergic and α-blocker combination therapy versus α-blocker alone in BPH patients with dominant irritative symptoms in a clinical trial during 2006. Eighty four patients who fulfilled the inclusion/exclusion criteria were randomly divided into two groups of tamsulosin monotherapy versus tamsulosin and an anticholinergic agent combination therapy. Therapeutic efficacy and safety were analyzed using international prostate symptom score (IPSS) and residual urine volume. Total IPSS was significantly improved in both groups.We considered Significant improvements in total IPSS were also seen for the combination therapy group (P= 0.0008 within group), but not for the monotherapy group.At the end of treatment, median PVR was not significantly higher for the co-therapy group (51.6mL) than for the monotherapy group (47.0 mL) (P= 0.173).There was no retention in either group. Combination of α-blocker and anticholinergics in BPH patients with dominant irritative symptoms is a reasonable and safe therapeutic option without any increase in urinary retention rate.