Efficacy and safety of α-blockers plus 5α-reductase inhibitors for benign prostatic hyperplasia: a systematic review and meta-analysis

This meta-analysis evaluated the efficacy and safety of combining alpha-adrenergic blockers (α-ABs) with 5α-reductase inhibitors (5α-RIs) for treating benign prostatic hyperplasia (BPH) in 9 randomized controlled trials involving 13,052 patients. The combination therapy significantly improved urinary symptoms, reduced prostate volume, increased urinary flow rate, and lowered PSA levels compared to α-AB monotherapy. It also decreased the risks of acute urinary retention and postoperative surgery, with no significant difference in cardiovascular adverse events. Despite some publication bias and heterogeneity, the findings support the use of combination therapy for BPH patients with severe symptoms and larger prostate volumes to achieve optimal outcomes.