rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2016-3-2-5rpmj-136Research ArticleОбзоры, лекцииReviews, lecturesСОВРЕМЕННЫЕ ВОЗМОЖНОСТИ КОМБИНИРОВАННОЙ ТЕРАПИИ СИМПТОМОВ НИЖНИХ МОЧЕВЫВОДЯЩИХ ПУТЕЙ НА ФОНЕ ДОБРОКАЧЕСТВЕННОЙ ГИПЕРПЛАЗИИ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ У МУЖЧИНCURRENT OPPORTUNITIES FOR COMBINATION TREATMENT OF LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA IN MENКасянГ. Р.KasyanG. R.

Касян Геворг Рудикович – доктор медицинских наук, профессор кафедры урологии

Gevorg R. Kasyan – MD, professor of urological department

КоноваловИ. В.KonovalovI. V.

Коновалов Иван Владимирович – старший медицинский советник.

Для корреспонденции:  АО «Астеллас Фарма» Адрес: 109147, Россия, Москва, ул. Марксистская, 16 E-mail: ivan.konovalov@astellas.com

Ivan V. Konovalov – senior advisor 

For correspondence: JSC "Astellas Pharma" Address: 16, ul. Marksistskaya,Moscow, 109147, Russia E-mail: ivan.konovalov@astellas.com

ivan.konovalov@astellas.comМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияA. Evdokimov Moscow State Medico-Stomatological University, MoscowRussian FederationАстеллас Фарма, МоскваРоссияAstellas Pharma JSC, MoscowRussian Federation201601072016323744Copyright © Касян Г.Р., Коновалов И.В., 20162016Касян Г.Р., Коновалов И.В.Kasyan G.R., Konovalov I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/136

Нарушения мочеиспускания, связанные с доброкачественной гиперплазией предстательной железы (ДГПЖ), являются распространенным заболеванием, особенно среди мужчин старшей возрастной группы. Считается, что симптомы нижних мочевых путей (СНМП) прямо или косвенно связаны с предстательной железой. Последние исследования показали, что тяжелые формы СНМП могут иметь различную этиологию. Например, проблемы, связанные с мочевым пузырем: гиперактивный мочевой пузырь (ГМП)/детрузорная гиперактивность или, наоборот, слабая сократительная активность детрузора. Выделяют три основные группы СНМП: симптомы накопления, симптомы опорожнения и симптомы после него. Пациенты с СНМП/ДГПЖ, у которых монотерапия альфа-блокаторами не позволяет эффективно купировать симптомы наполнения, должны получать дополнительное лечение М‑холиноблокаторами (антимускариновыми препаратами) в соответствии с рекомендациями Европейской Ассоциации Урологов (EAU). Результаты исследований показывают, что до 65% пациентов с СНМП/ДГПЖ, проявляющимися ургентным и учащенным мочеиспусканием, не отмечают улучшения после 3 месяцев лечения альфа-блокаторами в режиме монотерапии. До недавнего времени альфа-блокаторы и М‑холиноблокаторы назначались совместно в виде двух отдельных препаратов. В2015 г. в РФ был зарегистрирован комбинированный препарат Везомни®, специально разработанный для лечения смешанных симптомов на фоне ДГПЖ. Указанный препарат является комбинацией М‑холиноблокатора солифенацина в дозе 6 мг и альфа-блокатора (α1‑блокатора) тамсулозина в форме таблетки с контролируемым высвобождением (ОКАС) в дозе 0,4 мг. Он был разработан для устранения симптомов наполнения (ургентные позывы, учащенное мочеиспускание, ургентное недержание мочи) и опорожнения, сопровождающих ДГПЖ у мужчин. Солифенацин подавляет гиперактивность детрузора и снижает выраженность симптомов, связанных с накоплением мочи. Препарат тамсулозин в форме ОКАС расслабляет гладкую мускулатуру предстательной железы, ее капсулы, простатической части мочеиспускательного канала и шейки мочевого пузыря, и устраняет большинство симптомов опорожнения и, в меньшей степени, симптомы, связанные с накоплением мочи.

Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are widely presented, particularly among elderly men. It was commonly accepted that LUTS are directly or indirectly connected with the prostate. Recent studies have shown that mild andsevere forms of LUTS may have a different etiology, such as, bladder related problems: overactive bladder (OAB)/detrusor overactivity or, conversely, an underactive bladder due to compromised contractions of the detrusor. There are three main groups of LUTS: storage symptoms, voiding symptoms and post-micturition symptoms. Patients with LUTS/BPH who are not sufficiently respond to monotherapy with alpha-blockers should receive additional treatment with M‑anticholinergics in accordance with the European urological guidelines. Current studies show that up to 65% of patients with LUTS/BPH with symptoms of urgency and frequency do not have sufficient reduction of symptoms after 3 months of treatment with alphablocker as monotherapy. Until recently, alpha-blockers and M‑anticholinergic medications were prescribed in combination therapy as a two separate pills. Vesomni is a combination of antimuscarinic drug solifenacin 6 mg with α1‑blocker tamsulosin OCAS 0.4 mg in one tablet. It is developed to relieve storage (urgency and frequency) and voiding symptoms in men with LUTS/BPH. Solifenacin suppresses the overactivity of the detrusor and reduces storage symptoms. Tamsulosin OCAS relaxes smooth muscle of the prostate, prostatic urethra and bladder neck, and eliminates most voiding symptoms and, to a lesser extent, storage symptoms.

альфа-блокаторыдоброкачественная гиперплазия предстательной железыкомбинированная терапия СНМПМ-холиноблокаторысимптомы нижних мочевых путейalpha-blockersbenign prostatic hyperplasiacombination therapy of LUTSM-anticholinergicslower urinary tract symptomsReferencesAbrams P., Cardozo L., Fall M., Griffiths D., Rosier P., Ulmsten U., et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003; 61 (1): 37–49.Abrams P., Cardozo L., Fall M., Griffiths D., Rosier P., Ulmsten U., et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003; 61 (1): 37–49.Chung D. E., Sandhu J. S. Overactive bladder and outlet obstruction in men. Curr Urol Rep. 2011; 12 (1): 77–85. doi: 10.1007/s11934–010–0157 x.Chung D. E., Sandhu J. S. Overactive bladder and outlet obstruction in men. Curr Urol Rep. 2011; 12 (1): 77–85. doi: 10.1007/s11934–010–0157 x.Speakman M.J. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH): more than treating symptoms? Eur Urol Suppl. 2008; 7: 680–689.Speakman M.J. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH): more than treating symptoms? Eur Urol Suppl. 2008; 7: 680–689.Irwin D. E., Milsom I., Hunskaar S., Reilly K., Kopp Z., Herschorn S., et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006; 50 (6): 1306–1314.Irwin D. E., Milsom I., Hunskaar S., Reilly K., Kopp Z., Herschorn S., et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006; 50 (6): 1306–1314.Sexton C. C., Coyne K. S., Kopp Z. S., Irwin D. E., Milsom I., Aiyer L. P., et al. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int 2009; 103 (Suppl 3): 12–23. doi: 10.1111/j.1464–410X.2009.08369.x.Sexton C. C., Coyne K. S., Kopp Z. S., Irwin D. E., Milsom I., Aiyer L. P., et al. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int 2009; 103 (Suppl 3): 12–23. doi: 10.1111/j.1464–410X.2009.08369.x.Irwin D. E., Kopp Z. S., Agatep B., Milsom I., Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int 2011; 108: 1132–1138. doi: 10.1111/j.1464–410X.2010.09993.x. Epub 2011 Jan 13.Irwin D. E., Kopp Z. S., Agatep B., Milsom I., Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int 2011; 108: 1132–1138. doi: 10.1111/j.1464–410X.2010.09993.x. Epub 2011 Jan 13.Kupelian V., Wei J. T., O’Leary M. P., Kusek J.W., Litman H.J., Link C. L., et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med. 2006; 166 (21): 2381–2387.Kupelian V., Wei J. T., O’Leary M. P., Kusek J.W., Litman H.J., Link C. L., et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med. 2006; 166 (21): 2381–2387.Coyne K. S., Wein A.J., Tubaro A., Sexton C. C., Thompson C. L., Kopp Z. S., et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int 2009; 103 (Suppl 3): 4–11. doi: 10.1111/j.1464–410X.2009.08371.x.Coyne K. S., Wein A.J., Tubaro A., Sexton C. C., Thompson C. L., Kopp Z. S., et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int 2009; 103 (Suppl 3): 4–11. doi: 10.1111/j.1464–410X.2009.08371.x.Emberton M., Marberger M., de la Rosette J. Understanding patient and physician perceptions of benign prostatic hyperplasia in Europe: the Prostate Research on Behaviour and Education (PROBE) Survey. Int J Clin Pract. 2008; 62 (1): 18–26.Emberton M., Marberger M., de la Rosette J. Understanding patient and physician perceptions of benign prostatic hyperplasia in Europe: the Prostate Research on Behaviour and Education (PROBE) Survey. Int J Clin Pract. 2008; 62 (1): 18–26.Sells H., Donovan J., Ewings P., MacDonagh R. P. The development and validation of a quality-of-life measure to assess partner morbidity in benign prostatic enlargement. BJU Int 2000; 85 (4): 440–445.Sells H., Donovan J., Ewings P., MacDonagh R.P. The development and validation of a quality-of-life measure to assess partner morbidity in benign prostatic enlargement. BJU Int 2000; 85 (4): 440–445.Peters T.J., Donovan J. L., Kay H. E., Abrams P., de la Rosette J.J., Porru D., et al. The International Continence Society “Benign Prostatic Hyperplasia” study: the bothersomeness of urinary symptoms. J Urol. 1997; 157 (3): 885–889.Peters T.J., Donovan J. L., Kay H. E., Abrams P., de la Rosette J.J., Porru D., et al. The International Continence Society “Benign Prostatic Hyperplasia” study: the bothersomeness of urinary symptoms. J Urol. 1997; 157 (3): 885–889.Häkkinen J. T., Hakama M., Huhtala H., Shiri R., Auvinen A., Tammela T. L., et al. Impact of LUTS using bother index in DANPSS 1 questionnaire. Eur Urol. 2007; 51 (2): 473–477.Häkkinen J. T., Hakama M., Huhtala H., Shiri R., Auvinen A., Tammela T. L., et al. Impact of LUTS using bother index in DANPSS 1 questionnaire. Eur Urol. 2007; 51 (2): 473–477.Asplund R. Nocturia: consequences for sleep and daytime activities and associated risks. Eur Urol. 2005; 3 (Suppl): 24–32.Asplund R. Nocturia: consequences for sleep and daytime activities and associated risks. Eur Urol. 2005; 3 (Suppl): 24–32.Gravas S., Bach T., Bachmann A., Drake M., Gacci M., Gratzke C., et al. EAU guidelines on the management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO) 2016. Available at: http://uroweb.org/wp-content/uploads/EAU-Guidelines-Management-of-non-neurogenicmale-LUTS 2016.pdf (дата обращения: 01.02.2016).Gravas S., Bach T., Bachmann A., Drake M., Gacci M., Gratzke C., et al. EAU guidelines on the management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO) 2016. Available at: http://uroweb. org/wp-content/uploads/EAU-Guidelines-Management-ofnon-neurogenic-male-LUTS 2016.pdf (Accessed: 01.02.2016).McVary K. T., Roehrborn C.G., Avins A. L., Barry MJ., Bruskewitz R. C., Donnell R.F, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 2011;185 (5): 1793–1803. doi: 10.1016/j.juro.2011.01.074. Epub 2011 Mar 21.McVary K. T., Roehrborn C.G., Avins A. L., Barry MJ., Bruskewitz R. C., Donnell R.F, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 2011;185 (5): 1793–1803. doi: 10.1016/j.juro.2011.01.074. Epub 2011 Mar 21.Roehrborn C.G. Clinical management of lower urinary tract symptoms with combined medical therapy. BJU Int. 2008; 102 Suppl 2: 13–17. doi: 10.1111/j.1464–410X.2008.08088.x.Roehrborn C.G. Clinical management of lower urinary tract symptoms with combined medical therapy. BJU Int. 2008; 102 Suppl 2: 13–17. doi: 10.1111/j.1464–410X.2008.08088.x.van Kerrebroeck P., Jardin A., Laval K.U., van Cangh P. Efficacy and safety of a new prolonged release formulation of alfuzosin 10 mg once daily versus alfuzosin 2.5 mg thrice daily and placebo in patients with symptomatic benign prostatic hyperplasia. Eur Urol. 2000; 37: 306–313.van Kerrebroeck P., Jardin A., Laval K.U., van Cangh P. Efficacy and safety of a new prolonged release formulation of alfuzosin 10 mg once daily versus alfuzosin 2.5 mg thrice daily and placebo in patients with symptomatic benign prostatic hyperplasia. Eur Urol. 2000; 37: 306–313.Chapple C. R., Al-Shukri S.H., Gattegno B., et al. Tamsulosin Oral Controlled Absorption System (OCAS) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH): efficacy and tolerability in a placebo and active comparator controlled phase 3a study. Eur Urol. 2005; 4 Suppl: 33–44.Chapple C. R., Al-Shukri S.H., Gattegno B., et al. Tamsulosin Oral Controlled Absorption System (OCAS) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH): efficacy and tolerability in a placebo and active comparator controlled phase 3a study. Eur Urol. 2005; 4 Suppl: 33–44.Narayan P., Evans C. P., Moon T. Long-term safety and efficacy of tamsulosin for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia. J Urol. 2003; 170: 498–502.Narayan P., Evans C. P., Moon T. Long-term safety and efficacy of tamsulosin for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia. J Urol. 2003; 170: 498–502.Chapple C. R., Roehrborn C.G. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol. 2006; 49: 651–658.Chapple C. R., Roehrborn C.G. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol. 2006; 49: 651–658.Lee J. Y., Kim H.W., Lee S.J., Koh J. S., Suh H.J., Chancellor M. B., et al. Comparison of doxazosin with or without tolterodine in men with symptomatic bladder outlet obstruction and an overactive bladder. BJU Int. 2004; 94 (6): 817–820.Lee J. Y., Kim H.W., Lee S.J., Koh J. S., Suh H.J., Chancellor M. B., et al. Comparison of doxazosin with or without tolterodine in men with symptomatic bladder outlet obstruction and an overactive bladder. BJU Int. 2004; 94 (6): 817–820.McVary KT. BPH: epidemiology and comorbidities. Am J Manag Care. 2006; 12: S122–128.McVary K. T. BPH: epidemiology and comorbidities. Am J Manag Care. 2006; 12: S122–128.Кривобородов Г. Г. Симптомы нижних мочевыводящих путей. Урология. 2014; 1: 49–54.Krivoborodov G.G. Lower urinary tract symptoms in men. Urologiia. 2014; 1: 49–54.Гаджиева З. К., Казилов Ю. Б., Аляев Ю. Г., Абоян И. А., Казилов Б. Р. Нарушения мочеиспускания. Все ли мы о них знаем? Урология. 2014; 1: 20–26.Gadzhieva Z. K., Kazilov Yu. B., Alyaev Yu.G., Aboyan I. A., Kazilov B. R. Urination disorders. Do we know all about them? Urologiia. 2014; 1: 20–26. (Russian).Пушкарь Д.Ю., Раснер П.И. Опыт применения холинолитиков в лечении больных с аденомой предстательной железы с симптомами нижних мочевыводящих путей. Урология. 2011; 2: 80–85.Pushkar D.Yu., Rasner P. I. Experience in administration of cholinolytics in the treatment of patients with prostatic adenoma and symptoms of the lower urinary tract. Urologiia. 2011; 2: 80–85. Russian).Велиев Е.И., Голубцова Е.Н., Дадашев Э.О. Необходимость и безопасность комбинированной лекарственной терапии пациентов с нарушениями мочеиспускания. Урология. 2012; 4: 92–96.Veliyev E. I., Golubtsova E.N., Dadashev E.O. Necessity and safety of combined drug therapy in patients with urination disorders. Urologiia. 2012; 4: 92–96. (Russian).MacDiarmid S. A., Peters K. M., Chen A., Armstrong R. B., Orman C., Aquilina J. W., et al. Efficacy and safety of extended-release oxybutynin in combination with tamsulosin for treatment of lower urinary tract symptoms in men: randomized, double-blind, placebocontrolled study. Mayo Clin Proc 2008; 83 (9): 1002–1058. doi: 10.4065/83.9.1002.MacDiarmid S. A., Peters K. M., Chen A., Armstrong R. B., Orman C., Aquilina J. W., et al. Efficacy and safety of extended-release oxybutynin in combination with tamsulosin for treatment of lower urinary tract symptoms in men: randomized, double-blind, placebocontrolled study. Mayo Clin Proc 2008; 83 (9): 1002–1058. doi: 10.4065/83.9.1002.Chapple C., Herschorn S., Abrams P., Sun F., Brodsky M., Guan Z.. Tolterodine treatment improves storage symptoms suggestive of overactive bladder in men treated with alpha-blockers. Eur Urol. 2009; 56 (3): 534–541. doi: 10.1016/j. eururo.2008.11.026. Epub 2008 Nov 24.Chapple C., Herschorn S., Abrams P., Sun F., Brodsky M., Guan Z.. Tolterodine treatment improves storage symptoms suggestive of overactive bladder in men treated with alpha-blockers. Eur Urol. 2009; 56 (3): 534–541. doi: 10.1016/j. eururo.2008.11.026. Epub 2008 Nov 24.Kaplan SA, McCammon K, Fincher R, Fakhoury A, He W. Safety and tolerability of solifenacin add-on therapy to -blocker treated men with residual urgency and frequency. J Urol. 2009; 182 (6): 2825–2830. doi: 10.1016/j.juro.2009.08.023. Epub 2009 Oct 17.Kaplan SA, McCammon K, Fincher R, Fakhoury A, He W. Safety and tolerability of solifenacin add-on therapy to -blocker treated men with residual urgency and frequency. J Urol. 2009; 182 (6): 2825–2830. doi: 10.1016/j.juro.2009.08.023. Epub 2009 Oct 17.Yamaguchi O., Kakizaki H., Homma Y., Takeda M., Nishizawa O., Gotoh M., et al. Solifenacin as add-on therapy for overactive bladder symptoms in men treated for lower urinary tract symptoms-ASSIST, randomized controlled study. Urology. 2011; 78 (1): 126–133. doi: 10.1016/j.urology.2011.02.055. Epub 2011 May 23.Yamaguchi O., Kakizaki H., Homma Y., Takeda M., Nishizawa O., Gotoh M., et al. Solifenacin as add-on therapy for overactive bladder symptoms in men treated for lower urinary tract symptoms-ASSIST, randomized controlled study. Urology. 2011; 78 (1): 126–133. doi: 10.1016/j.urology.2011.02.055. Epub 2011 May 23.Berry S.J., Coffey D. S., Walsh P. C., Ewing L. L. The development of human benign prostratic hyperplasia with age. J Urology. 1984; 132 (3): 474–479.Berry S.J., Coffey D. S., Walsh P. C., Ewing L. L.. The development of human benign prostratic hyperplasia with age. J Urology. 1984; 132 (3): 474–479.Van Kerrebroeck P., Chapple C., Drogendijk T., Klaver M., Sokol R., Speakman M., et al; NEPTUNE Study Group. Combination therapy with solifenacin and tamsulosin oral controlled absorption system in a single tablet for lower urinary tract symptoms in men: efficacy and safety results from the randomised controlled NEPTUNE trial. Eur Urol. 2013; 64 (16): 1003–1012. doi: 10.1016/j.eururo.2013.07.034. Epub 2013 Aug 3.Van Kerrebroeck P., Chapple C., Drogendijk T., Klaver M., Sokol R., Speakman M., et al; NEPTUNE Study Group. Combination therapy with solifenacin and tamsulosin oral controlled absorption system in a single tablet for lower urinary tract symptoms in men: efficacy and safety results from the randomised controlled NEPTUNE trial. Eur Urol. 2013; 64 (16): 1003–1012. doi: 10.1016/j.eururo.2013.07.034. Epub 2013 Aug 3.Drake M.J., Chapple C., Sokol R., Oelke M., Traudtner K., Klaver M., et al. Long-term safety and efficacy of single-tablet combinations of solifenacin and tamsulosin oral controlled absorption system in men with storage and voiding lower urinary tract symptoms: results from the NEPTUNE Study and NEPTUNE II open-label extension. Eur Urol. 2015; 67 (2): 262–270. doi: 10.1016/j.eururo.2014.07.013. Epub 2014 Jul 25.Drake M.J., Chapple C., Sokol R., Oelke M., Traudtner K., Klaver M., et al. Long-term safety and efficacy of single-tablet combinations of solifenacin and tamsulosin oral controlled absorption system in men with storage and voiding lower urinary tract symptoms: results from the NEPTUNE Study and NEPTUNE II open-label extension. Eur Urol. 2015; 67 (2): 262–270. doi: 10.1016/j.eururo.2014.07.013. Epub 2014 Jul 25.Nazir J., Heemstra L., van Engen A., Hakimi Z., Ivanescu C. Cost-effectiveness of a fixed-dose combination of solifenacin and oral controlled adsorption system formulation of tamsulosin in men with lower urinary tract symptoms associated with benign prostatic hyperplasia. BMC Urol. 2015 May 9;15:41. doi: 10.1186/s12894–015–0031–8.Nazir J., Heemstra L., van Engen A., Hakimi Z., Ivanescu C. Cost-effectiveness of a fixed-dose combination of solifenacin and oral controlled adsorption system formulation of tamsulosin in men with lower urinary tract symptoms associated with benign prostatic hyperplasia. BMC Urol. 2015 May 9;15:41. doi: 10.1186/s12894–015–0031–8.

The authors declare that there are no conflicts of interest present.