Utilidad de los antagonistas de los receptores muscarínicos en el tratamiento de los varones con síntomas del tracto urinario inferior secundarios a HBP

Use of antimuscarinic agents in male patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) and with symptoms of overactive bladder (OAB) has become increasingly relevant over the last few years. Prescription of these drugs is in conflict with a long-established concept learnt in Medical School: antimuscarinics are contraindicated in patients with BPH. Several factors, however, have placed this issue under constant review. The description of OAB syndrome and the scientific research carried out over recent years have provided epidemiological and pathophysiological data worthwhile reviewing, most importantly in order to understand why a review of such a solidly established concept has been raised. This paper reviews the prevalence of OAB in men with BPH, the role of urodynamics to evaluate men with OAB and the existing evidence on the effect antimuscarinics have in terms of efficacy and safety on male patients with detrusor obstruction and overactivity.