Comparative Effectiveness of Tadalafil versus Tamsulosin in Treating Lower Urinary Tract Symptoms Suggestive of Benign Prostate Hyperplasia: A Meta-Analysis of Randomized Controlled Trials

BACKGROUND Evidence directly evaluating the efficacy of tadalafil vs. tamsulosin for lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) is limited. We performed a meta-analysis of published studies to assess the comparative effectiveness of tadalafil vs. tamsulosin in treating LUTS suggestive of BPH. MATERIAL AND METHODS After performing a comprehensive publication search with PubMed, EMBASE, and Cochrane Controlled Trials Register using the search terms "tadalafil", "tamsulosin", "lower urinary tract symptoms", and "controlled", 335 articles were screened, out of which 7 randomized controlled trials published up to July 2019 were identified and included in this meta-analysis review. RESULTS From 335 screened articles, 7 studies (totalling 1601 patients) were finally included in our analysis. There was no statistically significant difference between tadalafil and tamsulosin in improving the clinical outcomes of total International Prostate Symptom Score (IPSS),voiding subscores, storage subscores, quality of life (QoL) scores, maximum flow rate (Qmax), and postvoid residual urine (PVR), but a statistically significant difference was observed in the International Index of Erectile Function scores (IIEF scores). CONCLUSIONS Tadalafil and tamsulosin have similar effects in managing LUTS secondary to BPH. Tadalafil is superior to tamsulosin in treating LUTS suggestive of BPH when associated with erectile dysfunction (ED).