Combination of alfa blocker with low dose tadalafil in benign prostatic hyperplasia with erecticle dysfunction management

Objective: To study the combination therapy with daily low dose tadalafil (5mg) and alpha blockers for the treatment of BPHLUTS and Erecticle dysfunction (ED). Materials and Methods: The medical records of 168 patients who had medical management for symptomatic BPH/LUTS with or without ED from January 2010 to December 2013 were reviewed retrospectively. All patients were divided into 2 groups. Group1(n: 74) included patients received a single daily dose of tamsulosin 0.4mg or alfuzosin 10mg . Group-2 (n:75) patients with LUTS and BPH who were previously managed with alpha blockers (tamsulosin 0.4mg or alfuzosin 10mg) were included in our study by addition of 5mg phosphodiesterase type 5 inhibitor (tadalafil), which has been reported to be useful in the management of BPH/LUTS and ED. We analysed the International Prostate Symptom Score (IPSS), IIEF Score, BPH Impact Index (BII) and Quality of Life (QoL). Results: Before the inclusion of tadalafil patients exclusively on alpha blockers had a mean IPSS score of 21.51 ± 2.89). IPSS improved to a mean of 11.34 ± 1.56 ( p<0.001) after the addition of a single daily dose of 5mg tadalafil. A previous mean BPH Impact Index of 8.52 ± 1.22( p><0.001) improved to 4.38± 0.89 (p><0.001). Quality of Life index was graded with a mean of 3.76 ± 1.10 before addition of tadalafil and improved to a mean of 2.22 ± 0.76 ( p><0.001). IIEF-5 scores changed from 15.54 ± 3.68 to 7.89 ± 3.84 (p><0.001), after 12 weeks of treatment. Conclusion: We recommend tadalafil 5mg once daily dose for BPH/LUTS patients with higher IPSS score, diabetes, smaller prostate and inoperable patients.>