Interchangeable alternative use of tadalafil and selective a1-blocker versus their combined daily use

Abstract

Background and Aims. Lower urinary tract symptoms (LUTS) in association with benign prostatic hyperplasia (BPH) are frequent complaints among middle-aged men. Surgical intervention has represented the gold standard management for this condition for decades. Anyhow, there has been a significant turn towards medical therapy in BPH management. The currently accepted standard strategy for LUTS/BPH management includes α-adrenergic blockers, 5α-reductase inhibitors, phosphodiesterase inhibitor and phytotherapies. Combined use of Tadalafil & Selective α1-blocker are approved to improve LUTS. The tool used to screen Symptoms/Benign Prostatic Hyperplasia often  The International Prostate Symptom Score (IPSS) which is a seven-question related to voiding symptoms written to assess disease severity and response to therapy.. The study aimed to assess reduction in Lower urinary tract symptoms with interchangeable alternative use of Tadalafil & selective a1-blocker and to compare its therapeutic effect to combined daily use . Patients and method.32 men age (50-70y), nondiabetic   nor hypertensive, complaining of LUTS due to BPH was included. All patients received silodosin 8'mg/day combined with tadalafil 10 mg/day for 3months, After 3 months the treatment program has been changed as all same patient group received silodosin 8mg & tadalafil 10mg day by day. Results. The mean LUTS before treatment was13.88, the mean difference with use of combined treatment of Tadalafil & Selective α1-blocker was 11.53, while mean difference with using interchangeable alternative treatment was 11.47. Deference in both treatment modalities was statistically insignificant at P value (< 0.05). Complications of each treatment modality were compared and the results were better in interchangeable alternative treatment with statistically significant variation in retrograde ejaculation, flush and nasal congestion, and gastric upset. Conclusion. In patients with LUTS due to BPH, no statistically significant difference in therapeutic value between daily use of combination of Tadalafil 10mg & Selective α1-blocker and switch interchangeable use of both of the two drugs, while there is statistically significant less side effect observed with switch interchangeable use.  

Keywords: International Prostate Symptoms Score, Tadalafil  & Selective α 1- blocker, benign prostatic hyperplasia , Lower urinary tract symptoms.