Kombinationstherapie bei LUTS: Wann Pillen und wann nicht?

Abstract

To improve the efficacy of medical treatment of patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), studies on combination treatment with alpha(1)-blockers and 5alpha-reductase inhibitors, alpha(1)-blockers and muscarinic receptor antagonists, and alpha(1)-blockers and 5-phosphodiesterase inhibitors are increasingly performed. The most substantial data are available on the combination of alpha(1)-blockers and 5alpha-reductase inhibitors. This combination is not suitable for symptom improvement alone but for inhibition of progression. A combination therapy of alpha(1)-blockers and muscarinic receptor antagonists cannot be recommended as routine because of the still limited, although promising, data. Only preliminary data are available for the combination of alpha(1)-blockers and 5-phosphodiesterase inhibitors, which do not show convincing advantages over other combinations.