Efficacy and Safety of Tadalafil, Tamsulosin, and Their Combinations in Treating Lower Urinary Tract Symptoms in BPH Patients with Prostate Volumes ≤ 40 Ml: a Prospective Comparative Study
Shaker, H., abdalaziz, A., ElAdawy, M., Ibrahim, R., Yousef, A., Abdelatif, A., heikal, S., AbdElhamid, M., Dogha, M., Abdalgalil, A., Yousif, H. (2025). Efficacy and Safety of Tadalafil, Tamsulosin, and Their Combinations in Treating Lower Urinary Tract Symptoms in BPH Patients with Prostate Volumes ≤ 40 Ml: a Prospective Comparative Study. EKB Journal Management System, (), -. doi: 10.21608/eju.2025.388743.1032
Hossam Shaker; assem abdalaziz; Mahmoud Shoukry ElAdawy; Rabie M Ibrahim; Ahmed Yousef; Ahmed Abdelatif; samia heikal; Mahmoud AbdElhamid; Mohamed Mahmoud Dogha; Ahmed Abdalgalil; Hamada Ahmed Yousif. "Efficacy and Safety of Tadalafil, Tamsulosin, and Their Combinations in Treating Lower Urinary Tract Symptoms in BPH Patients with Prostate Volumes ≤ 40 Ml: a Prospective Comparative Study". EKB Journal Management System, , , 2025, -. doi: 10.21608/eju.2025.388743.1032
Shaker, H., abdalaziz, A., ElAdawy, M., Ibrahim, R., Yousef, A., Abdelatif, A., heikal, S., AbdElhamid, M., Dogha, M., Abdalgalil, A., Yousif, H. (2025). 'Efficacy and Safety of Tadalafil, Tamsulosin, and Their Combinations in Treating Lower Urinary Tract Symptoms in BPH Patients with Prostate Volumes ≤ 40 Ml: a Prospective Comparative Study', EKB Journal Management System, (), pp. -. doi: 10.21608/eju.2025.388743.1032
Shaker, H., abdalaziz, A., ElAdawy, M., Ibrahim, R., Yousef, A., Abdelatif, A., heikal, S., AbdElhamid, M., Dogha, M., Abdalgalil, A., Yousif, H. Efficacy and Safety of Tadalafil, Tamsulosin, and Their Combinations in Treating Lower Urinary Tract Symptoms in BPH Patients with Prostate Volumes ≤ 40 Ml: a Prospective Comparative Study. EKB Journal Management System, 2025; (): -. doi: 10.21608/eju.2025.388743.1032

Efficacy and Safety of Tadalafil, Tamsulosin, and Their Combinations in Treating Lower Urinary Tract Symptoms in BPH Patients with Prostate Volumes ≤ 40 Ml: a Prospective Comparative Study

Egyptian Journal of Urology
Articles in Press, Accepted Manuscript, Available Online from 06 July 2025  XML
Document Type: Original Article
DOI: 10.21608/eju.2025.388743.1032
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Authors
Hossam Shaker1; assem abdalaziz1; Mahmoud Shoukry ElAdawy2; Rabie M Ibrahim3; Ahmed Yousef4; Ahmed Abdelatif4; samia heikal5; Mahmoud AbdElhamid6; Mohamed Mahmoud Dogha email orcid 7; Ahmed Abdalgalil1; Hamada Ahmed Yousif8
1Department of Urology, Faculty of Medicine, Fayoum University, Egypt
2fayoum university- faculty of medicine
3urology , medicine, benisuif university
4urology, medicine, benisuif university
5Diagnostic Radiology Department, National Cancer Institute, Cairo University
6Department of Urology, Faculty of Medicine, Cairo University, Egypt
7keman fares
8urology department, faculty of medicine, fayoum university
Abstract
Abstract:

Objective: elicit influence of tadalafil and tamsulosin versus their combinations in treatment of LUTS in prostates < 40 ml.

Materials and methods: A prospective randomized study conducted at Fayoum University Hospital from April 2023 to August 2024. A total of 95 participants > 45 years, with mild to intense LUTS, were enrolled. Participants were randomized into three groups: Tamsulosin group (0.4 mg per day), tadalafil group (5 mg per day), and combined group. International Prostate Symptom Score was the primary parameter. Secondary parameters were IIEF-5 items , maximum urinary flow rate, post-void residual urine, and quality of life. At baseline, these parameters were assessed, followed by evaluations at 1, 3, and 6 months.

Results: IPSS score significanly increased in tamsulosin group relative to tadalafil group (p < 0.001) and in combination group relative to tadalafil group (p < 0.001). IIEF-5 scores also highly significantly enhanced in tadalafil group, with scores of 21.30±1.06 compared with 15.90±3.41 in tamsulosin group (p = 0.001) after treatment. Additionally, Q-max enhanced significantly in tamsulosin group, with an average of 13.07±1.29 ml/sec, whereas it was 11.73±0.90 ml/sec in tadalafil group (p = 0.001). Both PVR and IPSS QoL scores enhanced notably in tamsulosin and combination groups relative to those in tadalafil group. Importantly, no significant unfavorable events were reported in any group.

Conclusion: patients with prostates <40 ml, tamsulosin and tadalafil are safe and efficient therapies for LUTS. When compared to tadalafil, tamsulosin considerably improved LUTS, and combined treatment produced better outcomes than tamsulosin alone.
Keywords
Tamsulosin; tadalafil; BPH and LUTS
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