Current role of treatment in male lower urinary tract symptoms combined with overactive bladder

Lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are highly prevalent in older men. The storage subcategory of LUTS is synonymous with overactive bladder syndrome (OAB) which is an empirical diagnosis. Traditionally, alpha-blockers are widely prescribed to manage LUTS of BPH, although storage symptoms may persist in many men despite treatment. Therefore, since therapies that target the prostate often fail to alleviate storage symptoms, they may not be the appropriate therapy for overactive bladder (OAB). In past years, most physicians appear to give more weight in elderly men to voiding symptoms than to storage symptoms, and they are more concerned with initial treatment with anticholinergics for males with storage symptoms. Considering the recent increasing data about the efficacy and safety of combination treatment of alpha receptor antagonists and antimuscarinic agents, the standard pharmacologic treatment of patients with LUTS combined with OAB should be an alpha receptor antagonists and antimuscarinic agent. Beta 3 adreno receptor agonists may potentially also be useful for the treatment of male LUTS combined with OAB.