Authors
Dr. Vivek Sharma, Senior Resident, Department of Urology, Government Medical College, Trivandrum
Dr. Abhinav Kumar, Senior Resident, Department of Urology, Government Medical College, Trivandrum
Prof. Vasudevan S, Professor, Department of Urology, Government Medical College, Trivandrum
Abstract
Introduction and Objective: Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) is quite complex to manage . Many drugs with various mechanisms of action are available Since erectile dysfunction commonly accompanies LUTS, drugs covering both these disorders shall be advantageous. We evaluated the efficacy of combination of tamsulosin and tadalafil in patients with LUTS without ED
Methodology: prospective randomized study in which patients with LUTS without any erectile dysfunction within the age group of 45 – 65 yrs and prostate gland size up to 50 cc were enrolled for three months and patients were assessed for International Prostatic Symptom Score (IPSS), quality of life (IPSS QoL), maximum urinary flow rate (Qmax) and post-void residual urine (PVR) volume before and at 3 months of treatment and this data was analysed
Results: Mean IPSS score in groups 1, 2, 3 & 4 were 22.81, 23.06, 23.30, 24.32 respectively which after three month drug treatment were noted to be 16.91, 11.31, 12.07 & 8.11. The difference in the maximum flow rate were statistically significant. Mean QoL scores before and after the study were 5.25, 4.81, 5.17 & 4.76 and 2.88, 2.15, 2.20 & 1.55 respectively , the change being statiscally significant (p < 0.001).The improvement in mean peak flow rate were also very remarkable. The mean Qmax rates initially in groups 1, 2, 3 & 4 were 10.81, 10.80, 10.77 & 10.82 ml/sec respectively which after three months became 11.62, 17.43, 12.75 & 18.86 ml/sec respectively. PVR reduced significantly in group 2 and 4.
Conclusion: From the results and analysis of our study we can conclude that combination Tadalafil and α-Blocker therapy is superior to tamsulosin or tadalafil alone for Benign Prostatic Hyperplasia in patients with LUTS even in patients not having erectile dysfunction for improving IPSS, QoL and Qmax significantly but not significant change in post-voidal residue.