Is tamsulosin and tadalafil a safe and effective treatment for lower urinary tract symptoms?

This study aimed to compare the effectiveness and safety of tamsulosin (Flomax) versus tamsulosin and tadalafil (Cialis) for the treatment of lower urinary tract symptoms (LUTS). The main finding was that the combination treatment appeared to improve LUTS more than treatment with tamsulosin alone, with no difference in side effects.

LUTS may include involuntary loss of urine (incontinence), needing to pass urine frequently, or discomfort when passing urine. Tamsulosin is commonly used to treat LUTS. It works by relaxing the muscles in the prostate and the bladder. Tadalafil is used to treat male sexual dysfunction. It works by increasing blood flow to the penis. It is thought that tadalafil may be effective when used in combination with other drugs for the treatment of LUTS. 

This study included 140 men over the age of 45 with moderate LUTS. Participants were split into two groups. Those in group 1 received tamsulosin and a placebo. Those in group 2 received tamsulosin and tadalafil in combination. 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, erectile function, maximum urine flow rate and the volume of urine left in the bladder after urination were also measured.

52.50% of those in group 1 and 80% in group 2 showed an IPSS improvement of at least 3 points. This was set as an important difference at the beginning of the study. Those in group 2 also showed greater improvements in quality of life and in maximum urine flow rate following treatment compared to those in group 1. There was no difference in the volume of urine left in the bladder after urination between the two groups following treatment.

There were no serious side effects following treatment. 2.85% of patients in both groups stopped treatment due to side effects. The most common side effect was muscle pain (1 participant in group 1 and 3 participants in group 2).

This study suggested that tamsulosin and tadalafil were more effective combined than tamsulosin alone for the treatment of LUTS,  with similar side effects.

This study included patients treated in one hospital only. Therefore, the results may not be applicable to patients treated elsewhere.

If you have concerns about the treatment of LUTS, please consult your doctor.