1254 THE ASSOCIATION OF TAMSULOSIN AND DAILY TADALAFIL FOR THE TREATMENT OF LOWER URINARY TRACT SYMPTOMS IS SAFE AND EFFECTIVE?

Field: Medicine (Health Sciences)

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Medical and Hormonal Therapy1 Apr 20121254 THE ASSOCIATION OF TAMSULOSIN AND DAILY TADALAFIL FOR THE TREATMENT OF LOWER URINARY TRACT SYMPTOMS IS SAFE AND EFFECTIVE? Ricardo Reges, Rommel Regadas, Manoel Odorico Moraes Filho, Francisco Vagnaldo Fechine Jamacaru, João Batista Cerqueira, and Lúcio Flávio Gonzaga Ricardo RegesRicardo Reges Fortaleza, Brazil More articles by this author , Rommel RegadasRommel Regadas Fortaleza, Brazil More articles by this author , Manoel Odorico Moraes FilhoManoel Odorico Moraes Filho Fortaleza, Brazil More articles by this author , Francisco Vagnaldo Fechine JamacaruFrancisco Vagnaldo Fechine Jamacaru Fortaleza, Brazil More articles by this author , João Batista CerqueiraJoão Batista Cerqueira Fortaleza, Brazil More articles by this author , and Lúcio Flávio GonzagaLúcio Flávio Gonzaga Fortaleza, Brazil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1572AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Some studies have observed that patients with erectile dysfunction (ED) treated with inhibitory phosphodiesterase type 5 (PDE5) improves erection and lower urinary tract symptoms (LUTS). Thus, there is interest in evaluating whether PDE5 is an option for the treatment of LUTS. However, despite the knowledge that there is improvement in LUTS, not known whether PDE5 works during storage, emptying, or both? Not yet known if the association PDE5 with alpha blocker is better than its use alone or whether this association is safe? The aim of this study were to evaluate the safety of the combination of tamsulosin with daily tadalafil as well as its effect on LUTS by urodynamic study. METHODS It was performed a randomized clinical trial, double-blind, placebo-controlled study during the period October 2010 to September 2011. All patients had LUTS associated with benign prostatic hyperplasia (BPH) and were evaluated with International Prostate Symptom Score (I-PSS) and urodynamic study at baseline and 30 days after treatment. Patients were separated into two groups Group 1 - daily tadalafil 5mg and tamsulosin 0.4 mg and Group 2 - tamsulosin 0.4 mg and placebo. RESULTS The age of patients was similar, 61.6 years in group 1 and 59.2 years in Group 2 (P = 0.19). The average volume of the prostate in Group 1 was 44.3 mL and 42.4 mL in Group 2. When comparing the groups with respect to prostate volume, there was no significant difference (P = 0.28). The association of tamsulosin with tadalafil 5mg was more effective in improving the total score of the I-PSS and voiding sub-score. But comparing the groups there is no difference between the storage sub-score, Quality of Life, maximum flow and detrusor pressure at maximum flow (Table 1). Table 1. Efficacy and effectiveness association of tamsulosin with daily tadalafil. Intervention (no. of patients assessed) Baseline [mean (SD)] Endpoint [mean (SD)] Within group difference (within group P-value) Between group difference (P-value) Total International Prostate Symptom Score (I-PSS) Group 1 (20) 20.55 10.35 -10.2 (P < 0.001) -4.15 (P=0.013) Group 2 (20) 20.35 14.51 -5.85 (P < 0.001) Filling sub-score Group 1 (20) 7.3 3.4 -3.9 (P < 0.001) -0.8 (P=0.209) Group 2 (20) 5.75 4.2 -1.55 (P < 0.001) Voiding sub-score Group 1 (20) 13.4 7.1 -6.3 (P < 0.001) -2.9 (P=0.011) Group 2 (20) 14.15 10.0 -4.15 (P < 0.001) Quality of Life (QoL) sub-score Group 1 (20) 4.8 2.55 -2.25 (P < 0.001) -0.15 (P=0.32) Group 2 (20) 4 2.70 1.30 (P < 0.001) Maximum flow (ml/s) Group 1 (20) 6.25 7.30 1.05 (P=0.03) -1.8 (P=0.053) Group 2 (20) 7.45 9.1 1.65 (P=0.003) Detrusor pressure at maximum flow (cmH2O) Group 1 (20) 65.3 53.5 -11.8 (P=0.008) 1.8 (P=0.39) Group 2 (20) 50 51.7 1.7 (P=0.39) Group 1 - daily tadalafil 5mg and tamsulosin 0.4 mg and Group 2 - tamsulosin 0.4 mg and placebo It was observed that 13 (65%) patients in Group 1 and 8 (40%) in Group 2 had detrusor overactivity (DO). However, after treatment DO disappeared in seven (54%) in Group 1 and three (37%) in Group 2. There were no cardiovascular side effects as hypotension and dizziness, which resulted in discontinuation of treatment in patients treated with tadalafil and tamsulosin. CONCLUSIONS The combination of tamsulosin and tadalafil daily is safe and better than the isolated use of tamsulosin to treat patients with lower urinary tract symptoms associated with benign prostatic hyperplasia. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e507 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ricardo Reges Fortaleza, Brazil More articles by this author Rommel Regadas Fortaleza, Brazil More articles by this author Manoel Odorico Moraes Filho Fortaleza, Brazil More articles by this author Francisco Vagnaldo Fechine Jamacaru Fortaleza, Brazil More articles by this author João Batista Cerqueira Fortaleza, Brazil More articles by this author Lúcio Flávio Gonzaga Fortaleza, Brazil More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...