Comparative Study of Tadalafil and Tamsulosin as on therapy For Lower Urinary Tract Symptoms Due To Benign Hyperplasia of Prostate.

Abstract

Objectives: The U.S. Food and Drug Administration approved tadalafil in 2011 to treat the signs and symptoms of Lower Urinary Tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Tadalafil is a phosphodiesterase-5 (PDE5) inhibitor improves erectile function by increasing the amount of cyclic guanosine monophosphate in the smooth muscle of the corpus cavernosa. This study aims for the comparison of tadalfil with other established drug tamsulosin in south asian population Methods: A total of 120 patient presenting with lower urinary tract symptoms( LUTS) due to BPH were selected and randomized with card method to receive either 5mg tadalafil daily or 0.4 mg tamsulosin daily. Base line Q max , PVR(post void residual), IPSS(International prostate symptom score), IIEF(International index of erectile function-erectile function) were noted at start of study and at end of 12 weeks. Patient with history of drug treatment, history of prostate surgery and raised PSA were excluded from study. Results: Both group were comparable. Both tamsulosin and tadalafil improved symptoms of LUTS. But tamsulosin is slightly more effective than tadalafil but not significantly ( p > 0.05) in relieving LUTS. But only tadalafil significantly improved IIEF (p<0.05). Both treatments were tolerated well. There was component of subclinical erectile dysfunction in 36 out of 60. Conclusion: Symptoms of erectile dysfunction and LUTS frequently occurs together. These could well be treated with monotherapy of tadalafil. It is still not clear significance of treating subclinical erectile dysfunction.