Intended for healthcare professionals


Measuring symptomatic relief in men with lower urinary tract symptoms

BMJ 2014; 349 doi: (Published 07 November 2014) Cite this as: BMJ 2014;349:g6664
  1. Marco H Blanker, general practitioner and epidemiologist1,
  2. Kenny R van Deventer, editor2,
  3. Dick Bijl, chief editor2
  1. 1Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, NL 9700 AD, Groningen, Netherlands
  2. 2Geneesmiddelenbulletin, Mercatorlaan Utrecht, Netherlands
  1. Correspondence to: M H Blanker blanker{at}

Most currently used drugs have been given too easy a ride

Lower urinary tract symptoms are common in the ageing population and have many causes.1 In men the various symptoms are still often attributed to benign prostatic hyperplasia, whatever their true cause2 and despite the remarks repeatedly made about nomenclature.3 Recently published guidelines and reviews on the evaluation and treatment of men with lower urinary tract symptoms rate four categories of drugs as efficacious: α blockers, 5-α reductase inhibitors, anticholinergics, and phosphodiesterase-5 inhibitors. 1 2 4 5

We are surprised at how highly these drugs are recommended given how well they work. While treatment effects are reported as being significantly better than those of placebo, we wonder whether the small differences in patient-reported symptom scores are perceptible to patients.

Most drugs used for these symptoms were investigated using the International Prostate Symptom Score (IPSS), …

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