Patients with benign prostatic hyperplasia (BPH) frequently have concurrent overactive bladder (OAB), a combination that drives significant urinary frequency and urgency burden. Addressing both conditions together requires a structured pharmacological approach.
This protocol is for patients with benign prostatic hyperplasia who also have overactive bladder. The coexistence of BPH and OAB compounds lower urinary tract symptoms and calls for management that accounts for both diagnoses simultaneously.
The approach involves pharmacotherapy, with both single-agent and combination options available. One pathway uses a targeted monotherapy; another pairs an alpha blocker with an additional bladder-directed agent. Shared decision-making guides the choice between non-invasive, pharmacological, and minimally invasive options.
The primary objective is meaningful improvement in urinary frequency and urgency symptoms.
DOI: 10.1097/JU.0000000000003985
Clinicians should offer patients with BPH and OAB monotherapy with antimuscarinic medications or beta-3 agonists, or combination therapy with an alpha blocker and an antimuscarinic medication or beta-3 agonist.
The clinician may offer patients with BPH and bothersome OAB, in the context of shared decision-making, initial management with non-invasive therapies, pharmacotherapy, or minimally invasive therapies.
Combination therapy was associated with significant improvements in frequency and urgency symptoms.
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