During the plenary session on the lower urinary tract, Prof. Chris Chapple (GB) led an interesting series of presentations on new developments in drug therapy for lower urinary tract symptoms (LUTS). The latest data on PDE5 inhibitors, beta-3 agonists, botuliniumA toxin, and combination therapies were extensively covered. During a short discussion following the presentations, the speakers had a chance to elaborate on the advantages, limitations, and future developments of the treatment options they presented.
“Urologists need to maintain control over this complex and multifaceted condition,” said Chapple. Although recent developments may have radically changed drug treatment of LUTS, more research is needed.
Prof. Matthias Oelke (DE) presented data on the PDE5 inhibitor tadalafil. He pointed out that due to the fact that many men with LUTS also suffer from erectile dysfunction (ED), there is a significant reduction of symptom bother in patients treated with tadalafil. Adverse events of the PDE5 inhibitor are also minor. The beta-3 agonist mirabegron seems to diminish symptom bother without the common side effects of dry mouth or constipation.
“BotuliniumA toxin has revolutionised the treatment of OAB,” said Prof. Thomas Kessler (CH) when presenting the latest study results on the substance. However, he too, called for more research, especially for comparative studies on different botuliniumA subtypes.
Mr. Mark Speakman (GB) presented an update on the research in the field of combination therapies. He stressed that individual treatment will become more important and combination therapies will play a key role in this development. He warned, however, that combination therapy is expensive and side effects can pile up. Speakman therefore also urged the audience to keep an eye on surgical innovation.
The session and discussion called for innovation and further research but also showed that treatment of LUTS continues to develop. Speakman concluded: “The use of combination therapy will eventually be more effective than the strategy of making existing drugs more powerful.”