Comparison of Safety and Efficacy Between Silodosin Monotherapy and Silodosin with Tadalafil Add-on Therapy in Patients with Benign Prostatic Hyperplasia

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Dr. Mohammad Abdus Salam, Dr. Md. Nabid Alam, Dr. Mohammed Rafiqul Islam, Dr. Mohammad Nazrul Islam, Dr. Mohammad Faroque Eastiak

Abstract

Background: In aging men, benign prostatic hyperplasia (BPH) causes bothersome lower urinary tract symptoms. Silodosin improves urinary flow by targeting alpha-1 receptors. Combining silodosin with tadalafil enhances symptom relief through synergistic smooth muscle relaxation, offering better management of BPH-related discomfort. This study aimed to compare the safety and efficacy of silodosin monotherapy with silodosin and tadalafil add-on therapy in Benign prostatic hyperplasia patients. Methods: This was a prospective observational study that was conducted in the department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Bangladesh from January 2022 to December 2022. This study randomized 80 patients, age between 40-80 years with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) into two groups. Group A (40 patients) received silodosin 8 mg daily, while Group B (40 patients) received silodosin 8 mg plus tadalafil 5 mg daily. SPSS 23.0 analyzed data. Results: A comparison of IPSS scores between Group A and Group B showed significant reductions in both groups (p<0.001). Similarly, Post-Void Residual (PVR) volumes decreased significantly in both groups (p<0.001). Q-MAX scores and International Index of Erectile Function (IIEF) scores significantly improved in both groups (p<0.001). Group B demonstrated slightly greater reductions in IPSS and PVR, and greater improvements in Q-MAX and IIEF. Adverse effects were minimal, with slightly more cases of peripheral edema and dyspepsia in Group B. Conclusion: Silodosin monotherapy and Silodosin with Tadalafil add-on therapy significantly improve IPSS, PVR, Q-MAX, and IIEF scores. The combination therapy shows slightly better results, with minimal adverse effects. For better outcomes, combination therapy is recommended for moderate to severe symptoms

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