Combination therapy improves both LUTS and ED

Combining the alpha-blocker alfuzosin SR (Uroxatral) with the phosphodiesterase type-5 inhibitor sildenafil citrate (Viagra) appears to produce a greater therapeutic benefit in men with lower urinary tract symptoms than either drug alone, researchers said yesterday.

After 12 weeks of treatment, International Prostate Symptom Scores (IPSS) dropped nearly five points, from 17.3 to 13.5, in men receiving combination therapy, compared with a 3.2-point drop with the alpha-blocker alone and a 2.0-point drop with the PDE-5 inhibitor alone. Scores on the International Index of Erectile Function (IIEF) improved 9.5 points in the combination therapy group compared to 2.9 points in the alpha-blocker group and 7.1 in the PDE-5 inhibitor group.

The study from New York Presbyterian Medical Center is one of several presented here showing that agents developed to treat erectile dysfunction, primarily PDE-5 inhibitors, also have beneficial effects on LUTS.

Lead author Steve Kaplan, MD, said that the findings presented here should encourage physicians to view male pelvic disorders as interrelated, not as isolated entities.

"We know that as men get older and develop significant urinating symptoms, they also tend to have significant sexual problems. It is not just age, but age is part of it. We need to be able to identify those men who would benefit from combination therapies designed to produce optimal results," Dr. Kaplan said.