Seven trials (515 patients, range 23 to 250) were included in the review. The overall quality of trials were reported as mainly low and moderate risk of bias but this did not appear to be reflected in the detailed results. Follow-up ranged from 60 days to three months.
For the treatment of erectile dysfunction, combination treatment with PDE5 inhibitors and alpha-blockers produced statistically significant increases in the IIEF scores compared with PDE5 inhibitors alone (MD 2.25, 95% CI 0.07 to 4.43; six trials; Ι²=78%).
For the treatment of lower urinary tract symptoms, combination treatment with PDE5 inhibitors and alpha-blockers produced statistically significant decreases in the IPSS score (MD -4.21, 95% CI -7.09 to -1.32; five trials; Ι²=93%) and increases in Qmax (MD 1.43, 95% CI 0.38 to 2.47; four trials; Ι²=0%).
There was no evidence of publication bias.