In a nutshell
This study evaluated the effectiveness of adding dutasteride (Avodart) to tadalafil (Cialis) for the treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). The data showed that adding dutasteride to tadalafil is a good treatment option for improving LUTS in these patients.
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. These patients often experience lower urinary tract symptoms (LUTS). These include symptoms such as difficulties emptying the bladder, urine leakage, or getting up to urinate during the night. These can be treated using medications. Alpha-(adrenoreceptor) blockers such as tamsulosin (Flomax) are often the first treatments used. These cause the bladder and prostate muscles to relax.
PDE5 inhibitors such as tadalafil have been shown to improve LUTS in patients with BPH. Tadalafil works by increasing the blood flow to the penis and helps to maintain an erection. Dutasteride is a commonly used medication for symptoms of BPH and LUTS. Dutasteride blocks the action of an enzyme that changes testosterone into an active compound. As a result, dutasteride can help reduce the size of the prostate gland. Additionally, dutasteride may decrease the need for surgery for BPH. When combined with an alpha-blocker, it was shown to be effective in improving LUTS in patients with BPH. However, studies evaluating the effectiveness of adding dutasteride to tadalafil for improving LUTS in patients with BPH are still unknown.
Methods & findings
This study involved 48 patients with BPH. All patients were suffering from LUTS and were not satisfied with tadalafil therapy alone after more than 3 months. Patients were treated with dutasteride plus tadalafil for 24 weeks. The International Prostate Symptom Score (IPSS) was measured before and after treatment. This questionnaire can be used to screen for, rapidly diagnose, and track the symptoms of LUTS. Quality of life (QoL), the maximum urine flow rate, and the volume of urine left in the bladder after urination were also measured.
Dutasteride plus tadalafil treatment significantly improved the patients' total IPSS scores and QoL. This combination also reduced the prostate volume from an average of 55 ml to 39 ml.
There was no difference in the maximum urine flow rate and the volume of urine left in the bladder after urination.
The improvement rate of IPSS scores and reduction rate of prostate volume were similar between patients treated with dutasteride plus tadalafil and dutasteride plus alpha-blocker from a previous study.
The bottom line
This study concluded that adding dutasteride to tadalafil is a good treatment option for improving LUTS in patients with BPH.
The fine print
The sample size was very small. This study only included patients treated at a single institution in Japan. This study lacked data on sexual function.
Published By :
International urology and nephrology
Apr 01, 2022