title: New strategies in treating male lower urinary tract symptoms.
abstract: OBJECTIVE
  Improved understanding of the pathogenesis of lower urinary tract symptoms (LUTS) has led to the development of new drugs to treat male LUTS. The review aims to give an overview to the new drugs and to compounds in the pipeline.
  
  
  RESULTS
  Tadalafil, a phosphodiesterase type 5 inhibitor, is a drug newly approved for the treatment of male LUTS and a true new challenger for the current standard treatment with alpha1 blockers, particularly in men with concomitant erectile dysfunction. Botulinum toxin and mirabegron, a beta3 agonist, might be of value in treating persistent storage LUTS. Intraprostatic injections with botulinum toxin, NX-1207, and PRX302, need further evaluation but might be treatment alternatives in the future. Similarly, vitamin D3 receptor analogues (e.g., elocalcitol), gonadotropin-releasing hormone antagonists (e.g., cetorelix), and modulators of the cannabinoid system (e.g., fatty acid amide hydrolase inhibitors) need further evaluation in clinical studies. Other compounds, such as transient receptor potential vanilloid antagonists, Rho kinase inhibitors, purinergic receptor blockers, and endothelin targeting drugs, are still at experimental stages.
  
  
  CONCLUSIONS
  Novel drugs for the treatment of male LUTS have been introduced recently. Clinical practice along with further trials will have to prove their value, along with other compounds that are still in their early phase of development.
authors.affiliation: aDepartment of Urology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany bDivision of Urology, Federal University of São Paulo (RS), São Paulo, Brazil.
authors.forename: Claudius
authors.initials: C
authors.lastname: Füllhase
authors.forename: Roberto
authors.initials: R
authors.lastname: Soler
authors.forename: Christian
authors.initials: C
authors.lastname: Gratzke
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use; D058667:Adrenergic beta-3 Receptor Agonists / Q000627:therapeutic use; D000818:Animals; D015507:Drugs, Investigational / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects / Q000503:physiopathology; D064804:Urological Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D058891:5-alpha Reductase Inhibitors; D058668:Adrenergic alpha-1 Receptor Antagonists; D058667:Adrenergic beta-3 Receptor Agonists; D015507:Drugs, Investigational; D018727:Muscarinic Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D064804:Urological Agents