Abstract

Lower urinary tract symptoms (LUTS) are common bothersome association with benign prostatic enlargement (BPE). The relationship between erectile dysfunction(ED) and LUTS/ BPE has been studied in the Multinational Survey of the Aging Male and in several epidemiologic studies, suggesting that the two diseases may share a common pathophysiology. The aim of the present study is to evaluate the efficacy and safety of use of tadalafil monotherapy in improving LUTS in patients with symptomatic BPE. Sixty patients aged more than 50 years with symptomatic BPE with LUTS more than 6 months were included from January 2013 to May 2015. These patients were assessed for their International Prostate Symptoms Score (IPSS) which was ≥7 and maximum urinary flow rate (Q max) which was >10 and < 20 ml/s. Patients were given tadalafil tablet 5 mg once daily without other therapy. The treatment was continued for three months and the patients were asked to come back for follow up each four weeks. Among the 60 patients, 50 (83.3%) showed significant improvement in their IPSS by achieving ≥3- points total IPSS improvement in symptoms. There was also significant improvement in the maximum urinary flow rate. The end point was at 12 weeks. It is concluded that, Tadalafil 5 mg once daily can be considered as an option for relieving LUTS in patients with symptomatic BPE

Highlights

  • Lower urinary tract symptoms (LUTS) are common bothersome association with benign prostatic enlargement (BPE)[1]

  • Tadalafil 5 mg once daily can be considered as an option for relieving LUTS in patients with symptomatic BPE

  • 60 patients aged more than 50 years with symptomatic BPE with LUTS more than 6 months were included from January 2013 to May 2015

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Summary

Introduction

Lower urinary tract symptoms (LUTS) are common bothersome association with benign prostatic enlargement (BPE)[1]. The current standard treatments for LUTS / BPE consist of α1adrenergic blockers, 5α-reductase inhibitors and phytotherapies (used alone or in combination). Efficacious, these therapies carry the potential for side effects related to sexual dysfunction[7,8]. The underlying mechanism for the relationship between LUTS and ED is still poorly understood. It is thought that common links such as RhoA/Rho-kinase signaling, over activity of the autonomic system, pelvic ischemia and the nitric oxide/ cyclic guanosinemonophosphate (NO/ cGMP) pathway to be potential targets for phosphodiesterase type 5inhibitors (PDE5-Is)[11,12,13,14]. A variety of (PDE5-Is), including sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis) and avanafil (Stendra) is widely approved for treating

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