Comparative Efficacy of Tamsulosin vs Tadalafil and Tamsulosin: In Treatment of Lower Urinary Tract Symptoms Secondary To Benign Prostatic Hypertrophy (BPH)

Abstract

INTRODUCTION
Benign prostatic hypertrophy (BPH) is common among aging men. Tamsulosin has long been used in medical management for troublesome Lower Urinary Tract Symptoms (LUTS). Tadalafil has demonstrated effectiveness in addressing LUTS  through several preclinical and clinical trials. We aim to assess the efficacy  of tamsulosin alone vs tadalafil with tamsulosin given in symptomatic patients of BPH in a tertiary care teaching institution.

MATERIAL AND METHODS
This prospective observational longitudinal study was conducted at Universal College of Medical Sciences, Bhairahawa from October 2021 to March 2023. A total of 140 patients with BPH were divided into 2 groups; tamsulosin only (0.4mg once daily) and tamsulosin (0.4mg once daily) + Tadalafil (5 mg once daily) group. IPSS, QoL (Quality of Life) were recorded on the first visit and then at 2, 6 and 12 weeks. Similarly, voided urinary volume, Qmax (maximum flow rate), PVR (post-voidal residual urine) were recorded at first visit and then after 2 weeks.

RESULTS
There was a significant improvement in the IPSS score, QoL, Qmax and PVR in both tamsulosin  group and tamsulosin + tadalafil group (p<0.001). The mean difference in improvement of IPSS score (10.8 vs 9.3), IPSS-QoL (2.73 vs 2.24), Qmax (4.9 vs 3.2) and PVR (36.87 vs 32.56) was more in tamsulosin + tadalafil group compared to tamsulosin group. Similarly, mean difference in IPSS score in 2nd and 3rd visit is better in the combination group.

CONCLUSION
The combination of tamsulosin and tadalafil was superior to tamsulosin alone in terms of IPSS, IPSS-QoL, Qmax and PVR.