As displayed in Fig. 5 and Additional file 1: Table S1, the pooled WMD for change of IPSS, QoL, IIEF score, Qmax and PVR was 1.47 (95%CI: 1.25–1.69, P < 0.0001), 0.59 (95%CI: 0.22–0.97, P = 0.002), 2.83 (95%CI: 2.08–3.58, P < 0.0001), 0.87 (95%CI: 0.71–1.04, P < 0.0001) and 10.74 (95%CI: 3.53–17.96, P = 0.004), respectively, indicating PDE5-Is plus ABs had better effect on improving LUTS/BPH than ABs alone. Here, PDE5A is linked to benign prostatic hyperplasia.