Evaluating the effectiveness of tadalafil alone, silodosin alone, and the combination of both in the treatment of lower urinary tract symptoms in patients with benign prostatic hyperplasia.

This study evaluated the effectiveness of tadalafil (Cialis) alone, silodosin (Rapaflo) alone, and the combination of both in the treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). The data showed that a combination of tadalafil plus silodosin is more effective than either drug alone in treating 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 oral medications.

Alpha-(adrenoreceptor) blockers like silodosin 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 also helps to maintain an erection. However, whether combining silodosin and tadalafil works better in improving LUTS in patients with BPH compared to each drug alone is still unknown. 

This study involved 308 patients with BPH. All patients were suffering from LUTS. Patients were randomly assigned into 3 groups. Group 1 included 101 patients who received tadalafil alone. Group 2 included 102 patients who received silodosin alone. Group 3 included 105 patients who received both tadalafil plus silodosin. The average follow-up time was 12 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. Erectile function, quality of life (QoL), the maximum urine flow rate (Qmax), and the volume of urine left in the bladder after urination were also measured.

A combination of tadalafil plus silodosin significantly improved the total IPSS score, erectile function score, maximum urine flow rate, and the volume of urine left in the bladder after urination than with either drug alone.

Three months after treatment, the average maximum urine flow rate values were 14.4 ml/sec in group 1, 15.2 ml/sec in group 2, and 15.8 ml/sec in group 3. The average IPSS scores were 17.6 in group 1, 16.7 in group 2, and 15.6 in group 3.

This study concluded that a combination of tadalafil plus silodosin is more effective than either drug alone in treating LUTS in men with BPH.

The sample size was very small. The follow-up time was too short. This study only included patients treated at a single institution in Egypt.