Efficacy and Safety of Combination Comprising Tamsulosin and PDE5-Is, Relative to Monotherapies, in Treating Lower Urinary Tract Symptoms and Erectile Dysfunction Associated With Benign Prostatic Hyperplasia: A Meta-Analysis

Am J Mens Health. 2020 Nov-Dec;14(6):1557988320980180. doi: 10.1177/1557988320980180.

Abstract

We report safety and efficacy of a combination therapy, comprising tamsulosin and phosphodiesterase type 5 inhibitors (PDE5-Is), relative to monotherapy, to ascertain its potential in treating lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) secondary to benign prostatic hyperplasia (BPH) after 3 months' treatment. We screened MEDLINE, EMBASE, and the Cochrane Controlled Trials Register databases, for randomized controlled trials, and obtained eight articles comprising 1144 participants. Results showed that the combination group had superior outcomes with regard to International Prostate Symptom Score (IPSS) and Qmax, compared to the other two groups. The combination group also had superior efficacy with regard to International Index of Erectile Function (IIEF) than the tamsulosin group, but not over the PDE5-Is group. Further, the combination group showed better efficacy in IPSS voiding and quality of life (QoL) compared to the PDE5-Is group. An analysis of safety outcomes revealed extremely high adverse events (AEs) and pain in the combination group. However, therapy discontinuation due to pain and AEs did not increase with increase in AEs. Overall, our findings indicate that a combination of tamsulosin and PDE5-Is is superior to individual tamsulosin and PDE5-Is monotherapy, with regard to improving LUTS and ED secondary to BPH.

Keywords: general health and wellness; quality of life; sexual disorders; sexual dysfunction; sexual health; sexuality.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Drug Therapy, Combination
  • Erectile Dysfunction* / drug therapy
  • Erectile Dysfunction* / etiology
  • Humans
  • Lower Urinary Tract Symptoms* / drug therapy
  • Lower Urinary Tract Symptoms* / etiology
  • Male
  • Phosphodiesterase 5 Inhibitors / therapeutic use
  • Prostatic Hyperplasia* / complications
  • Prostatic Hyperplasia* / drug therapy
  • Quality of Life
  • Tadalafil / therapeutic use
  • Tamsulosin / therapeutic use
  • Treatment Outcome

Substances

  • Phosphodiesterase 5 Inhibitors
  • Tadalafil
  • Tamsulosin