Best with daily tadalafil in terms of lower urinary tract symptoms: What is the current situation among Turkish men?
Dikmen, AV1; Oskay, K2; Aktas, A1
1: Polatli Duatepe Government Hospital, Turkey; 2: Gazi Mustafa Kemal Hospital, Turkey
Objective: In our era of innovation and imagination, new treatment modalities for lower urinary tract symptoms and erectile dysfunction (ED) of men. The, inhibitors of phosphodiesterase type 5 (PDE-5i) and combination therapies are used in treatment of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) for patients whom also have coincident sypmtoms of ED. Depending on literature demonstrating the relationship between LUTS and ED, we have retrospectively evaluated the results of treatment of patients with LUTS/BPH with daily tadalafil 5mg.
Material & Method: The pretreatment and posttreatment results of 2000 men between 36-91 years, attending our urology clinic with LUTS and ED between January 2015 and September 2016 and being treated with daily tadalafil 5mg for BPH and ED for 12 weeks, were retrospectively evaluated. The results of International Prostate Symptom Score (IPSS), International Erectile Function Index (IIEF), maximum flow rate in uroflowmetry (Qmax), postvoiding residual volume(PVR) and patients compliance to treatment were retrospectively evaluated.
Result: The pretreatment and post treatment mean IPSS scores of patients, who had LUTS and ED, were 18.6±3.2 and 13.8±1.7, respectively(p<0.001) being statistically significant. The pretreatment and posttreatment mean values of Qmax of patients were 13.1±2.2ml/sec and 17.9±2.1ml/sec, respectively (p=0.04). The pretreatment and posttreatment mean IIEF scores were 26.1±2.2 and 39.1±2.4, respectively (p=0.04). The mean PVR values before and after treatment were 197.1±7.4ml and 125.1±5.2, respectively (p=0.21) and was not statistically significant. The statistical evaluation was made according to paired t-test on parametric assumptions. All the patients declared that their sypmtoms related with ED and LUTS had decreased, had been pleased with the treatment and wanted to continue the medication.
Conclusion: It is very practical provided that a single agent can overcome both of the problems of vital issues in mens’ life. In older men, there are many common risk factors such as aging, smoking, obesity, hypertension and diabetes in men with LUTS and ED. Although the α-blokers are still the first choice in medical treatment of LUTS due to BPH, in further ages, the progressive improvement in LUTS in men getting PDE-5i for ED attracts more attention to the promising role of PDE-5i in treatment of LUTS. In our retrospective study, the prominent improvement in mean posttreatment results of IPSS, IIEF and Qmax demonstrate the promising recovery in LUTS. Our results reflect the best in our population: Best expected results of men with daily tadalafil.
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