The use of tadalafil and tamsulosin in benign prostatic hyperplasia Review article
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Published:
Sep 30, 2021
Keywords:
tadalafil, tamsulosin, benign prostatic hyperplasia, treatment
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Abstract
Lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are common in aging men. There is a close relationship between LUTS complaints and erectile dysfunction. Alpha-blockers are usually considered the I-line treatment of BPH-related LUTS. Phosphodiesterase 5 inhibitors are the gold standard in the treatment of erectile dysfunction, and can also be used in patients with BPH-related LUTS with or without coexisting erectile dysfunction. This article presents the current state of knowledge regarding the use of an α-blocker (tamsulosin) and a phosphodiesterase- 5 inhibitor (tadalafil) in the treatment of benign prostatic hyperplasia.
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Juszczak , K., & Drewa, T. (2021). The use of tadalafil and tamsulosin in benign prostatic hyperplasia. Medycyna Faktow (J EBM), 14(3(52), 287-290. https://doi.org/10.24292/01.MF.0321.11
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References
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2. McVary KT, McKenna KE. The relationship between erectile dysfunction and lower urinary tract symptoms: epidemiological, clinical, and basic science evidence. Curr Urol Rep. 2004; 5(4): 251-7.
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6. Morelli A, Sarchielli E, Comeglio P et al. Phosphodiesterase type 5 expression in human and rat lower urinary tract tissues and the effect of tadalafil on prostate gland oxygenation in spontaneously hypertensive rats. J Sex Med. 2011; 8(10): 2746-60.
7. Vignozzi L, Gacci M, Cellai I et al. PDE5 inhibitors blunt inflammation in human BPH: a potential mechanism of action for PDE5 inhibitors in LUTS. Prostate. 2013; 73(13): 1391-402.
8. Morelli A, Comeglio P, Filippi S et al. Mechanism of action of phosphodiesterase type 5 inhibition in metabolic syndrome-associated prostate alterations: an experimental study in the rabbit. Prostate. 2013; 73(4): 428-41.
9. Fibbi B, Morelli A, Vignozzi L et al. Characterization of phosphodiesterase type 5 expression and functional activity in the human male lower urinary tract. J Sex Med. 2010; 7(1 Pt 1): 59-69.
10. Hatzimouratidis K. A review of the use of tadalafil in the treatment of benign prostatic hyperplasia in men with and without erectile dysfunction. Ther Adv Urol. 2014; 6(4): 135-47.
11. Oelke M, Giuliano F, Mirone V et al. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomised, parallel, placebo-controlled clinical trial. Eur Urol. 2012; 61: 917-25.
12. Oelke M, Shinghal R, Sontag A et al. Time to onset of clinically meaningful improvement with tadalafil 5 mg once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: analysis of data pooled from 4 pivotal, double-blind, placebo controlled studies. J Urol. 2015; 193: 1581-9.
13. Vlachopoulos C, Oelke M, Maggi M et al. Impact of cardiovascular risk factors and related comorbid conditions and medical therapy reported at baseline on the treatment response to tadalafil 5 mg once-daily in men with lower urinary tract symptoms associated with benign prostatic hyperplasia: an integrated analysis of four randomised, double-blind, placebo-controlled, clinical trials. Int J Clin Pract. 2015; 69: 1496-507.
14. Gacci M, Salvi M, Sebastianelli A et al. The use of a single daily dose of tadalafil to treat signs and symptoms of benign prostatic hyperplasia and erectile dysfunction. Res Rep Urol. 2013; 5: 99-111.
15. Donatucci CF, Brock GB, Goldfischer ER et al. Tadalafil administered once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a 1-year, open-label extension study. BJU Int. 2011; 107: 1110-6.
16. Gacci M, Corona G, Salvi M et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2012; 61: 994-1003.
17. Sebastianelli A, Spatafora P, Morselli S et al. Tadalafil Alone or in Combination with Tamsulosin for the Management for LUTS/BPH and ED. Curr Urol Rep. 2020; 21(12): 56.
18. Lepor H. Long-term evaluation of tamsulosin in benign prostatic hyperplasia: placebo-controlled, double-blind extension of phase III trial. \Tamsulosin Investigator Group. Urology. 1998; 51(6): 901-6.
19. Porst H, Oelke M, Goldfischer ER et al. Efficacy and safety of tadalafil 5 mg once daily for lower urinary tract symptoms suggestive of benign \prostatic hyperplasia: subgroup analyses of pooled data from 4 multinational, randomized, placebo-controlled clinical studies. Urology. 2013; 82: 667-73.
20. Salonia A, Bettocchi C, Boeri L et al; EAU Working Group on Male Sexual and Reproductive Health. European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction. Eur Urol. 2021; 80(3): 333-57. http://doi.org/10.1016/j.eururo. 2021.06.007.
2. McVary KT, McKenna KE. The relationship between erectile dysfunction and lower urinary tract symptoms: epidemiological, clinical, and basic science evidence. Curr Urol Rep. 2004; 5(4): 251-7.
3. Gravas S, Cornu JN, Gacci M et al. Management of non-neurogenic male LUTS. In: EAU Guidelines 2020. Arnhem, The Netherlands: EAU Guidelines Office; 2020 (access: 9.09.2021).
4. Mirone V, Sessa A, Giuliano F et al. Current benign prostatic hyperplasia treatment: impact on sexual function and management of related sexual adverse events. Int J Clin Pract. 2011; 65(9): 1005-13.
5. Giuliano F, Uckert S, Maggi M et al. The mechanism of action of phosphodiesterase type 5 inhibitors in the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia. Eur Urol. 2013; 63(3): 506-16.
6. Morelli A, Sarchielli E, Comeglio P et al. Phosphodiesterase type 5 expression in human and rat lower urinary tract tissues and the effect of tadalafil on prostate gland oxygenation in spontaneously hypertensive rats. J Sex Med. 2011; 8(10): 2746-60.
7. Vignozzi L, Gacci M, Cellai I et al. PDE5 inhibitors blunt inflammation in human BPH: a potential mechanism of action for PDE5 inhibitors in LUTS. Prostate. 2013; 73(13): 1391-402.
8. Morelli A, Comeglio P, Filippi S et al. Mechanism of action of phosphodiesterase type 5 inhibition in metabolic syndrome-associated prostate alterations: an experimental study in the rabbit. Prostate. 2013; 73(4): 428-41.
9. Fibbi B, Morelli A, Vignozzi L et al. Characterization of phosphodiesterase type 5 expression and functional activity in the human male lower urinary tract. J Sex Med. 2010; 7(1 Pt 1): 59-69.
10. Hatzimouratidis K. A review of the use of tadalafil in the treatment of benign prostatic hyperplasia in men with and without erectile dysfunction. Ther Adv Urol. 2014; 6(4): 135-47.
11. Oelke M, Giuliano F, Mirone V et al. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomised, parallel, placebo-controlled clinical trial. Eur Urol. 2012; 61: 917-25.
12. Oelke M, Shinghal R, Sontag A et al. Time to onset of clinically meaningful improvement with tadalafil 5 mg once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: analysis of data pooled from 4 pivotal, double-blind, placebo controlled studies. J Urol. 2015; 193: 1581-9.
13. Vlachopoulos C, Oelke M, Maggi M et al. Impact of cardiovascular risk factors and related comorbid conditions and medical therapy reported at baseline on the treatment response to tadalafil 5 mg once-daily in men with lower urinary tract symptoms associated with benign prostatic hyperplasia: an integrated analysis of four randomised, double-blind, placebo-controlled, clinical trials. Int J Clin Pract. 2015; 69: 1496-507.
14. Gacci M, Salvi M, Sebastianelli A et al. The use of a single daily dose of tadalafil to treat signs and symptoms of benign prostatic hyperplasia and erectile dysfunction. Res Rep Urol. 2013; 5: 99-111.
15. Donatucci CF, Brock GB, Goldfischer ER et al. Tadalafil administered once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a 1-year, open-label extension study. BJU Int. 2011; 107: 1110-6.
16. Gacci M, Corona G, Salvi M et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2012; 61: 994-1003.
17. Sebastianelli A, Spatafora P, Morselli S et al. Tadalafil Alone or in Combination with Tamsulosin for the Management for LUTS/BPH and ED. Curr Urol Rep. 2020; 21(12): 56.
18. Lepor H. Long-term evaluation of tamsulosin in benign prostatic hyperplasia: placebo-controlled, double-blind extension of phase III trial. \Tamsulosin Investigator Group. Urology. 1998; 51(6): 901-6.
19. Porst H, Oelke M, Goldfischer ER et al. Efficacy and safety of tadalafil 5 mg once daily for lower urinary tract symptoms suggestive of benign \prostatic hyperplasia: subgroup analyses of pooled data from 4 multinational, randomized, placebo-controlled clinical studies. Urology. 2013; 82: 667-73.
20. Salonia A, Bettocchi C, Boeri L et al; EAU Working Group on Male Sexual and Reproductive Health. European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction. Eur Urol. 2021; 80(3): 333-57. http://doi.org/10.1016/j.eururo. 2021.06.007.