Efficacy of Tamsulosin Alone versus Tamsulosin Plus Tadalafil in Treatment of LUTS due to BPH: A Comparative Study

Abstract

1. Background: Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) are common disorders whose prevalence increases with advancing age. Recent large-scale epidemiological studies reported a statistically significant association between these two conditions, independent of age and cardiovascular co-morbidities. Furthermore, a significant association between the increased severity of LUTS and the increased severity of ED has been confirmed. Objectives: The purpose of the study is to offer a clinical evaluation to verify the safety and efficacy of the combination of tamsulosin 0.4 mg/day plus tadalafil 5 mg/day vs. tamsulosin 0.4 mg/day alone to treat patients with LUTS due to BPH. Materials & Methods: This comparative study was conducted in the Department of Urology, Dhaka Medical College Hospital. The duration of this study was 1 year from April 2018 to March 2019. A total of 170 patients, with a history of symptomatic BPH who attended the Urology Outpatient Department, Dhaka Medical College Hospital, were selected as per inclusion and exclusion criteria. Of them, 85 patients were treated with tamsulosin 0.4mg/day in group A whereas 85 patients were treated with tamsulosin 0.4mg/day plus tadalafil 5mg/day in group B. The general medical condition of the patients was evaluated through history, physical examination. The size of the prostate and PVR were evaluated through ultra-sonogram, and Qmax was assessed with uroflowmetry. The outcome of the patient was assessed by IPSS, IPSS total, IPSS voiding subscore, IPSS storage subscore, IPSS nocturia questionnaire, QOL, International Index of Erectile Function (IIEF-5) questionnaire, Qmax, USG of KUBP with MCC with PVR. Follow-up will be recorded in 4 visits in screening, week 0 randomization, 6 and 12. Results: One hundred and forty patients completed the study. Improvements in IPSS score and IPSS-QOL were significant with both treatments but greater with.....