Tadalafil versus tamsulosin as combination therapy with 5-alpha reductase inhibitors in benign prostatic hyperplasia, urinary and sexual outcomes.
Alpha blockers
BPH
Finasteride
Tadalafil
Tamsulosin
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
03 Feb 2024
03 Feb 2024
Historique:
received:
01
08
2023
accepted:
10
10
2023
medline:
3
2
2024
pubmed:
3
2
2024
entrez:
3
2
2024
Statut:
epublish
Résumé
To compare the urological and sexual outcomes of using either tamsulosin/finateride or tadalafil/finasteride as combination therapies in patients with large prostate. Selection criteria included prostate volume > 40 ml and IPSS > 7. Patients with severe erectile dysfunction (IIEF-erectile functions ≤ 10) were excluded. Patients were randomized into group I (tamsulosin/finasteride) and group II (tadalafil/finasteride). The primary endpoint was to define urinary and sexual function changes (IPSS, IPSS-quality of life, urinary flow rates and IIEF domains) within each group. The secondary endpoint was to compare the treatment induced changes between both groups. At 4th and 12th weeks, 131 and 127 patients were available in both groups, respectively. Both groups showed significant LUTS improvement (IPSS changes: - 4.9 ± 2.7 and - 4.3 ± 2.9 at 4th week and - 6.1 ± 3 and - 5.4 ± 2.8 points by the 12th week in both groups, respectively). Group I had better average flow rates at both follow-up visits. Meanwhile, maximum flow rates were comparable in both groups at 12th week (13.5 ± 3.9vs. 12.6 ± 3.7, p > 0.05). In group I, all IIEF domains were significantly lowered at both visits (p < 0.05). Group II showed significant increase in IIEF-erectile function scores (1.3 ± 1.1 and 1.8 ± 1.2 at the 4th and 12th weeks) with a transient significant reduction of IIEF-orgasm and sexual desire noted only by the 4th week (- 0.8 ± 0.4 and - 0.6 ± 0.4, respectively). Within three months, both combinations are comparably effective in improving BPH related LUTS. Tamsulosin/finasteride provided significantly better Qmax only at 4th week. Tadalafil/finasteride had the advantage of improving sexual performance over the other combination.
Identifiants
pubmed: 38308714
doi: 10.1007/s00345-023-04735-y
pii: 10.1007/s00345-023-04735-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
70Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Lepor H (2007) Alpha blockers for the treatment of benign prostatic hyperplasia. Rev Urol 9(4):181–190
pubmed: 18231614
pmcid: 2213889
Gacci M et al (2014) Impact of medical treatments for male lower urinary tract symptoms due to benign prostatic hyperplasia on ejaculatory function: a systematic review and meta-analysis. J Sex Med 11(6):1554–1566
doi: 10.1111/jsm.12525
pubmed: 24708055
Giuliano F (2006) Impact of medical treatments for benign prostatic hyperplasia on sexual function. BJU Int 97 Suppl 2:34–38 (discussion 44-5)
doi: 10.1111/j.1464-410X.2006.06104.x
pubmed: 16507052
Song SH et al (2011) Effect of tamsulosin on ejaculatory function in BPH/LUTS. Asian J Androl 13(6):846–850
doi: 10.1038/aja.2011.25
pubmed: 21785445
pmcid: 3739550
Kaplan SA, Gonzalez RR (2007) Phosphodiesterase type 5 inhibitors for the treatment of male lower urinary tract symptoms. Rev Urol 9(2):73–77
pubmed: 17592540
pmcid: 1892621
Pattanaik S et al (2019) Phosphodiesterase inhibitors for lower urinary tract symptoms consistent with benign prostatic hyperplasia. BJU Int 124(1):27–34
doi: 10.1111/bju.14689
pubmed: 30681264
Gravas S et al (2020) EAU guidelines on management of non-neurogenic male LUTS. In: Proceedings of the EAU Annual Congress Amsterdam. ISBN 978-94-92671-07-3
Giuliano F et al (2013) The mechanism of action of phosphodiesterase type 5 inhibitors in the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia. Eur Urol 63(3):506–516
doi: 10.1016/j.eururo.2012.09.006
pubmed: 23018163
Vignozzi L et al (2013) PDE5 inhibitors blunt inflammation in human BPH: a potential mechanism of action for PDE5 inhibitors in LUTS. Prostate 73(13):1391–1402
doi: 10.1002/pros.22686
pubmed: 23765639
Pereira ML et al (2017) Effects of nitric oxide inhibitors in mice with bladder outlet obstruction. Int Braz J Urol 43(2):356–366
doi: 10.1590/s1677-5538.ibju.2015.0441
pubmed: 28328190
pmcid: 5433376
Nickel JC et al (2011) Comparison of dutasteride and finasteride for treating benign prostatic hyperplasia: the Enlarged Prostate International Comparator Study (EPICS). BJU Int 108(3):388–394
doi: 10.1111/j.1464-410X.2011.10195.x
pubmed: 21631695
Gratzke C et al (2015) EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 67(6):1099–1109
doi: 10.1016/j.eururo.2014.12.038
pubmed: 25613154
McVary KT et al (2011) Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 185(5):1793–1803
doi: 10.1016/j.juro.2011.01.074
pubmed: 21420124
Traish AM et al (2011) Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med 8(3):872–884
doi: 10.1111/j.1743-6109.2010.02157.x
pubmed: 21176115
Kiguradze T et al (2017) Persistent erectile dysfunction in men exposed to the 5alpha-reductase inhibitors, finasteride, or dutasteride. PeerJ 5:e3020
doi: 10.7717/peerj.3020
pubmed: 28289563
pmcid: 5346286
Gur S, Kadowitz PJ, Hellstrom WJ (2013) Effects of 5-α reductase inhibitors on erectile function, sexual desire and ejaculation. Expert Opin Drug Saf 12(1):81–90
doi: 10.1517/14740338.2013.742885
pubmed: 23173718
Carbone DJ, Hodges S (2003) Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life. Int J Impot Res 15(4):299–306
doi: 10.1038/sj.ijir.3901017
pubmed: 12934061
Favilla V et al (2016) Impact of combination therapy 5-α reductase inhibitors (5-ARI) plus alpha-blockers (AB) on erectile dysfunction and decrease of libido in patients with LUTS/BPH: a systematic review with meta-analysis. Aging Male 19(3):175–181
doi: 10.1080/13685538.2016.1195361
pubmed: 27310433
Welliver C et al (2014) Impact of alpha blockers, 5-α reductase inhibitors and combination therapy on sexual function. Curr Urol Rep 15(10):441
doi: 10.1007/s11934-014-0441-2
pubmed: 25118850
Casabe A et al (2014) Efficacy and safety of the coadministration of tadalafil once daily with finasteride for 6 months in men with lower urinary tract symptoms and prostatic enlargement secondary to benign prostatic hyperplasia. J Urol 191(3):727–733
doi: 10.1016/j.juro.2013.09.059
pubmed: 24096118
Glina S et al (2015) Sexual function in men with lower urinary tract symptoms and prostatic enlargement secondary to benign prostatic hyperplasia: results of a 6-month, randomized, double-blind, placebo-controlled study of tadalafil coadministered with finasteride. J Sex Med 12(1):129–138
doi: 10.1111/jsm.12714
pubmed: 25353053
Gotoh D et al (2022) Efficacy and safety of dutasteride with tadalafil add-on therapy in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. BMC Res Notes 15(1):288
doi: 10.1186/s13104-022-06183-0
pubmed: 36064733
pmcid: 9446813
Hutchison A et al (2007) The efficacy of drugs for the treatment of LUTS/BPH, a study in 6 European countries. Eur Urol 51(1):207–215 (discussion 215-6)
doi: 10.1016/j.eururo.2006.06.012
pubmed: 16846678
Sebastianelli A et al (2019) Tadalafil 5 mg alone or in combination with tamsulosin 0.4 mg for the management of men with lower urinary tract symptoms and erectile dysfunction: results of a prospective observational trial. J Clin Med 8(8):1126
doi: 10.3390/jcm8081126
pubmed: 31362410
pmcid: 6723816
Singh DV et al (2014) A comparative randomized prospective study to evaluate efficacy and safety of combination of tamsulosin and tadalafil vs. tamsulosin or tadalafil alone in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. J Sex Med 11(1):187–196
doi: 10.1111/jsm.12357
pubmed: 24165272
Gandhi J et al (2017) The impact and management of sexual dysfunction secondary to pharmacological therapy of benign prostatic hyperplasia. Transl Androl Urol 6(2):295–304
doi: 10.21037/tau.2017.03.57
pubmed: 28540239
pmcid: 5422692
Rigatti P et al (2003) A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 6(4):315–323
doi: 10.1038/sj.pcan.4500680
pubmed: 14663474
Gul A et al (2020) Effect of tadalafil on penile nitric oxide synthase and corporal smooth muscle in rats under dutasteride treatment. Aging Male 23(2):161–167
doi: 10.1080/13685538.2020.1739019
pubmed: 32160825