TY - JOUR
T1 - Efficacy and safety of initial combination treatment of an alpha blocker with an anticholinergic medication in benign prostatic hyperplasia patients with lower urinary tract symptoms
T2 - Updated meta-analysis
AU - Kim, Hyun Jung
AU - Sun, Hwa Yeon
AU - Choi, Hoon
AU - Park, Jae Young
AU - Bae, Jae Hyun
AU - Doo, Seung Whan
AU - Yang, Won Jae
AU - Song, Yun Seob
AU - Ko, Young Myoung
AU - Kim, Jae Heon
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: There is still controversy as to whether initial combination treatment is superior to serial addition of anticholinergics after maintenance or induction of alpha blockers in benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) Objective: The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic review and meta-analysis. Methods: We conducted a meta-analysis of improvement in LUTS using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). Results: In total, 16 studies were included in our analysis, with a total sample size of 3,548 subjects (2,195 experimental subjects and 1,353 controls). The mean change in total IPSS improvement from baseline in the combination group versus the alpha blocker monotherapy group was -0.03 (95% CI: -0.14-0.08). The pooled overall SMD change of storage IPSS improvement from baseline was -0.28 (95% CI: -0.40 -0.17). The pooled overall SMD changes of QoL, Qmax, and PVR were -0.29 (95% CI: -0.50 -0.07), 0.00 (95% CI: -0.08-0.08), and 0.56 (95% CI: 0.23-0.89), respectively. There was no significant difference in the number of acute urinary retention (AUR) events or PVR. Conclusions: Initial combination treatment of an alpha blocker with anticholinergic medication is efficacious for in BPH/LUTS with improved measures such as storage symptoms and QoL without causing significant deterioration of voiding function.
AB - Background: There is still controversy as to whether initial combination treatment is superior to serial addition of anticholinergics after maintenance or induction of alpha blockers in benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) Objective: The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic review and meta-analysis. Methods: We conducted a meta-analysis of improvement in LUTS using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). Results: In total, 16 studies were included in our analysis, with a total sample size of 3,548 subjects (2,195 experimental subjects and 1,353 controls). The mean change in total IPSS improvement from baseline in the combination group versus the alpha blocker monotherapy group was -0.03 (95% CI: -0.14-0.08). The pooled overall SMD change of storage IPSS improvement from baseline was -0.28 (95% CI: -0.40 -0.17). The pooled overall SMD changes of QoL, Qmax, and PVR were -0.29 (95% CI: -0.50 -0.07), 0.00 (95% CI: -0.08-0.08), and 0.56 (95% CI: 0.23-0.89), respectively. There was no significant difference in the number of acute urinary retention (AUR) events or PVR. Conclusions: Initial combination treatment of an alpha blocker with anticholinergic medication is efficacious for in BPH/LUTS with improved measures such as storage symptoms and QoL without causing significant deterioration of voiding function.
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U2 - 10.1371/journal.pone.0169248
DO - 10.1371/journal.pone.0169248
M3 - Article
C2 - 28072862
AN - SCOPUS:85009069297
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 1
M1 - e0169248
ER -