Background: Lower Urinary Tract Symptoms (LUTS) in men are a common clinical problem in urology and have\nbeen historically strictly linked to benign prostatic hyperplasia (BPH), which may lead to bladder outlet obstruction\n(BOO). New molecules have been approved and have entered the urologistsââ?¬â?¢ armamentarium, targeting new\nsignaling pathways and tackling specific aspects of LUTS. Objective of this review is to summarize the evidence\nregarding the new medical therapies currently available for male non-neurogenic LUTS, including superselective\nÃ?±1-antagonists, PDE-5 inhibitors, anticholinergic drugs and intraprostatic onabotulinum toxin injections.\nMethods: The National Library of Medicine Database was searched for relevant articles published between\nJanuary 2006 and December 2015, including the combination of ââ?¬Å?BPHââ?¬Â, ââ?¬Å?LUTSââ?¬Â, ââ?¬Å?medicalââ?¬Â and ââ?¬Å?newââ?¬Â. Each articleââ?¬â?¢s\ntitle, abstract and text were reviewed for their appropriateness and their relevance. One hundred forty eight\narticles were reviewed.\nResults: Of the 148 articles reviewed, 92 were excluded. Silodosin may be considered a valid alternative to nonselective\nÃ?±1-antagonists, especially in the older patients where blood pressure alterations may determine major\nclinical problems and ejaculatory alterations may be not truly bothersome. Tadalafil 5 mg causes a significant\ndecrease of IPSS score with an amelioration of patientsââ?¬â?¢ QoL, although with no significant increase in Qmax.\nAntimuscarinic drugs are effective on storage symptoms but should be used with caution in patients with\nelevated post-void residual. Intraprostatic injections of botulinum toxin are well-tolerated and effective, with a\nlow rate of adverse events; however profound ameliorations were seen also in the sham arms of RCTs evaluating\nintraprostatic injections.
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