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

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).

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. 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.

Current urology reports. 2020 Oct 27*** epublish ***

A Sebastianelli, P Spatafora, S Morselli, L Vignozzi, S Serni, K T McVary, S Kaplan, S Gravas, C Chapple, Mauro Gacci

Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy., Department of Experimental and Clinical Biomedical Sciences "Mario Serio," Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital, University of Florence, Florence, Italy., Department of Urology, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA., Department of Urology, University of Thessaly, Larissa, Greece., Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK., Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy. .

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