Adding Cialis to alpha-blocker therapy can improve urinary symptoms

This study examined the effects of combining tadalafil (Cialis) with silodosin (Rapaflo) for benign prostatic hyperplasia (BPH). Researchers reported improved urinary symptoms when tadalafil was added to silodosin treatment compared to silodosin alone.

Men with BPH often experience urinary symptoms that can significantly affect quality of life. An enlarged prostate puts pressure on the bladder. This can cause overactive bladder symptoms such as urinary urgency, frequency, and incontinence. Drugs that are commonly prescribed for BPH include alpha-blockers such as silodosin. Alpha-blockers work by relaxing the muscles in the prostate and bladder, allowing urine to flow more easily.

However, treatment involving only silodosin is often not effective enough in reducing urinary symptoms. Tadalafil can help improve urinary symptoms due to BPH. Tadalafil is a phosphodiesterase-5 inhibitor originally developed for erectile dysfunction. It increases blood flow to the penis and is also believed to relax muscle cells in the bladder and prostate. The combination of tadalafil and silodosin has not been fully studied.

The aim of this study was to examine the effects of adding tadalafil to treatment with silodosin.

The records of 103 men with BPH were analyzed. All men continued to experience moderate urinary symptoms after at least 4 weeks of treatment with silodosin. 51 men continued treatment with silodosin alone and 50 men were treated with tadalafil and silodosin. 2 men had discontinued combination therapy due to side effects. Changes in urinary symptoms were assessed at 8 weeks of treatment.

Combination therapy was associated with significantly greater improvements in urinary symptoms compared to silodosin alone. Self-reported symptoms, overactive bladder symptoms, and urinary flow rate were all more improved with combination therapy. Among patients with overactive symptoms, urinary urgency, urinary storage, and quality of life were significantly more improved with combination therapy.

No significant differences in side effects were observed. Three men treated with combination therapy experienced side effects. These included headache, heart palpitations, fluid retention and indigestion. One patient treated with silodosin alone experienced indigestion. 

Researchers concluded that adding tadalafil to silodosin treatment significantly improves urinary symptoms.

Studies that randomly assign patients to treatment groups are needed to confirm these findings.