Tadalafil Alone or in Combination with Tamsulosin for the Management for LUTS/BPH and ED

• Published in: Current urology reports 2020-10, Vol.21 (12), p.56-56, Article 56
• Main Authors: Sebastianelli, A., Spatafora, P., Morselli, S., Vignozzi, L., Serni, S., McVary, K. T., Kaplan, S., Gravas, S., Chapple, C., Gacci, Mauro
• Format: Article
• Language: English
• Subjects: Benign Prostatic Hyperplasia (K McVary; Benign Prostatic Hyperplasia (K McVary, Section Editor); Combined Modality Therapy; Erectile Dysfunction - drug therapy; Erectile Dysfunction - etiology; Humans; Lower Urinary Tract Symptoms - drug therapy; Lower Urinary Tract Symptoms - etiology; Male; Medicine; Medicine & Public Health; Nephrology; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - drug therapy; Randomized Controlled Trials as Topic; Section Editor; Tadalafil - therapeutic use; Tamsulosin - therapeutic use; Topical Collection on Benign Prostatic Hyperplasia; Treatment Outcome; Urological Agents - therapeutic use; Urology
• ISSN: 1527-2737; 1534-6285
• DOI: 10.1007/s11934-020-01009-7

Purpose of Review Aim of our systematic review is to evaluate and summarize the efficacy and safety of tadalafil alone or in combination with tamsulosin for the management of lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). Recent Findings Daily tadalafil, in particular 5 mg, according to retrieved studies, appears to be both safe and effective in treating LUTS/BPH and ED, compared with placebo or tamsulosin. The combination of daily tadalafil 5 mg and tamsulosin 0.4 mg allows a better improvement of LUTS compared with both the monotherapies, even if with an increased, but acceptable and tolerated, adverse events rate. After discontinuation of tamsulosin or tadalafil in patients previously treated with their combination, the improvement of LUTS retains significance compared with baseline. Summary Tadalafil 5 mg should be considered a primary treatment option for patients with LUTS/BPH and ED. Evidence highlight an excellent tolerability, safety, and effectiveness profile, both alone or in combination with tamsulosin 0.4 mg. A better efficacy on LUTS relief has been observed for combination therapy, preserving also sexual function. The further switch to monotherapy allows to preserve LUTS relief, but tadalafil only is able to retain ED improvement. Our results support the evidence for a more and more tailored and modular LUTS treatment.