Comparative study of tamsulosin, tadalafil, and combination of tamsulosin with tadalafil in the treatment of patients with lower urinary tract symptoms

Purpose: Benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) commonly coexist in aging men. Tamsulosin and tadalafil are widely used for lower urinary tract symptoms (LUTS) and ED, respectively. A combination of these 2 drugs might be useful to design new management strategies, as treatment of LUTS might affect ED. Furthermore, the effect of tadalafil alone or in combination with tamsulosin on LUTS has not been widely studied, especially in our country. We conducted a study to compare the effects of tamsulosin, tadalafil, and a combination of tamsulosin and tadalafil in patients with LUTS with or without ED. Materials and methods: In this observational study, 81 men with LUTS due to BPH were included. Patients were divided into 3 groups of 27 patients each. Group A received tamsulosin 0.4 mg/d alone, group B tadalafil 5 mg/d alone, and group C combination therapy (tamsulosin and tadalafil both). All patients were evaluated for the International Prostate Symptom Score (IPSS), the International Index of Erectile Function 5 score, the maximum urinary flow rate, and postvoid residual urine volume. Results: IPSS improvement was seen in all groups (−50.90%, P < 0.05; −28.57%, P < 0.05; and −54.83%, P < 0.05, respectively). An improvement in International Index of Erectile Function 5 was also seen in all 3 groups (+39.28%, P < 0.05; +45.9%, P < 0.05; and +55.4%, P < 0.05, respectively). Maximum urinary flow rate and postvoid residual also showed improvement in all 3 groups (33.9%, P < 0.05; 29.92%, P < 0.05; and 39.71%, P < 0.05 and −60.60%, P < 0.05; −48.51%, P < 0.05; and −62.18%, P < 0.05, respectively). Conclusion: In patients with LUTS due to BPH, tadalafil and tamsulosin, either alone or in combination, significantly reduce LUTS. In addition, these drugs significantly enhance erectile function in males with LUTS, whether taken alone or in combination. We found no statistically significant improvement in either the IPSS or the ED scores when comparing the combination group to the tamsulosin-alone and the tadalafil-alone groups.