Tadalafil versus tadalafil with sildosin in the management of symptomatic benign prostatic hyperplasia

Objectives To compare the safety and efficacy of tadalafil versus tadalafil with silodosin in the treatment of patients with symptomatic benign prostatic hyperplasia (BPH) and their effect on erectile function. Background Lower urinary tract symptoms and erectile dysfunction are two commonly associated conditions in patients with BPH and lead to worsening of the quality of life in the male population. For such cases, alpha-blockers and phosphodiesterase five inhibitors are used. Patients and methods A total of 100 men, having lower urinary tract symptoms owing to BPH with moderate and severe international prostatic symptom score (IPSS), were randomly divided into four equal groups of 25 patients each. The IPSS and International index of erectile function-5 (IIEF-5) were scored for all patients together with measuring postvoid residual urine (PVR) and maximum urine flow rate (Q-MAX) at the first visit and then follow-up was done on the third, sixth, and 12th weeks, with same parameters added to inquiry about any adverse effects. Results Tadalafil monotherapy statistically improved IPSS, IIEF, and Q-MAX, with P value less than 0.001 in groups I and III. Moreover, it showed a statistically significant reduction in PVR in the same groups, with P value less than 0.001. The same findings were in groups II and IV receiving the combination therapy, with P value less than 0.001, with numerically better results in all aspects of the study. Conclusion All patients tolerated both protocols of treatment with no statistically significant adverse effects. The combination therapy was superior to monotherapy in all aspects regarding IPSS, IIEF, PVR, and Q-MAX.