eISSN: 3023-6940
The New Journal of Urology
  • Home
  • Efficacy of combination of daily tadalafil and solifenacin in patients with storage symptom predominant lower urinary tract symptoms

Article Tools

Related Subjects

E-SUBMISSION

Original Research

Efficacy of combination of daily tadalafil and solifenacin in patients with storage symptom predominant lower urinary tract symptoms


1 Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Urology Department, Istanbul, Turkey

2 Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Urology Department, Istanbul, Turkey


DOI : 10.33719/yud.2023;18-1-1193181
New J Urol. 2023;18(1):41-47
ABSTRACT

ABSTRACT

Objective: To evaluate the efficacy of tadalafil 5mg+solifenacin 5mg combination in terms of lower urinary tract symptoms (LUTS) and erectile functions in benign prostate hyperplasia patients with predominant storage symptoms.

Material And Methods: Male patients over the age of 40 who presented with LUTS with predominant storage symptoms between January 2019 and December 2021 were included into the study. Daily tadalafil 5mg and solifenacin 5mg treatment were started to the patients. Overactive bladder symptom score (OABSS), international prostate symptom score (IPSS) for LUTS, and international erectile function index-erectile function (IIEF-EF) questionnaires were used for erectile function. Frequency of daily urinary frequency, frequency of nocturia, urgency and urinary incontinence were analyzed with a three-day bladder diary. Twelve weeks later, IPSS, OABSS and IIEF-EF scores of the patients were evaluated.

Results: When the symptom scores and bladder diaries of the patients before and after 12 weeks of treatment were compared, significant decrease in IPSS scores (both voiding, storage and total) (p<0.001 for each), significant increase in IIEF-EF scores (p<0.001), and significant increase in Qmax value elevation was observed. When the bladder diaries were compared, the number of daytime micturitions, the number of nocturia and the number of urgency decreased in the 12th month after tadalafil+solifenacin treatment (p<0.001).

Conclusions: The combination of tadalafil 5mg and solifenacin 5mg daily is an effective and safe treatment for male patients with storage symptoms predominant LUTS/ED.

Keywords: benign prostate hyperplasia, storage, tadalafil, solifenacin, erectile function

ABSTRACT

Objective: To evaluate the efficacy of tadalafil 5mg+solifenacin 5mg combination in terms of lower urinary tract symptoms (LUTS) and erectile functions in benign prostate hyperplasia patients with predominant storage symptoms.

Material And Methods: Male patients over the age of 40 who presented with LUTS with predominant storage symptoms between January 2019 and December 2021 were included into the study. Daily tadalafil 5mg and solifenacin 5mg treatment were started to the patients. Overactive bladder symptom score (OABSS), international prostate symptom score (IPSS) for LUTS, and international erectile function index-erectile function (IIEF-EF) questionnaires were used for erectile function. Frequency of daily urinary frequency, frequency of nocturia, urgency and urinary incontinence were analyzed with a three-day bladder diary. Twelve weeks later, IPSS, OABSS and IIEF-EF scores of the patients were evaluated.

Results: When the symptom scores and bladder diaries of the patients before and after 12 weeks of treatment were compared, significant decrease in IPSS scores (both voiding, storage and total) (p<0.001 for each), significant increase in IIEF-EF scores (p<0.001), and significant increase in Qmax value elevation was observed. When the bladder diaries were compared, the number of daytime micturitions, the number of nocturia and the number of urgency decreased in the 12th month after tadalafil+solifenacin treatment (p<0.001).

Conclusions: The combination of tadalafil 5mg and solifenacin 5mg daily is an effective and safe treatment for male patients with storage symptoms predominant LUTS/ED.

Keywords: benign prostate hyperplasia, storage, tadalafil, solifenacin, erectile function

Resources

  • 1.Madersbacher S, Sampson N, Culig Z. Pathophysiology of Benign Prostatic Hyperplasia and Benign Prostatic Enlargement: A Mini-Review. Gerontology. 2019; 65(5): 458-64. https://doi.org/10.1159/000496289
    CROSSREF
  • 2.Egan KB. The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates. Urol Clin North Am. 2016; 43(3): 289-97. https://doi.org/10.1016/j.ucl.2016.04.001
    CROSSREF
  • 3.
    CROSSREF
  • 4.Gacci M, Eardley I, Giuliano F, et al. Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2011; 60(4): 809-25. https://doi.org/10.1016/j.eururo.2011.06.037
    CROSSREF
  • 5.Cindolo L, Pirozzi L, Sountoulides P, et al. Patient's adherence on pharmacological therapy for benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS) is different: is combination therapy better than monotherapy? BMC Urol. 2015; 15: 96. https://doi.org/10.1186/s12894-015-0090-x
    CROSSREF
  • 6.Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Effectiveness of Solifenacin and Trospium for Managing of Severe Symptoms of Overactive Bladder in Patients With Benign Prostatic Hyperplasia. Am J Mens Health. 2016; 10(2): 157-63. https://doi.org/10.1177/1557988315595692
    CROSSREF
  • 7.Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Additional correction of OAB symptoms by two anti-muscarinics for men over 50 years old with residual symptoms of moderate prostatic obstruction after treatment with Tamsulosin. Aging Male. 2015; 18(1): 44-8. https://doi.org/10.3109/13685538.2014.951922
    CROSSREF
  • 8.Nomiya M, Burmeister DM, Sawada N, et al. Prophylactic effect of tadalafil on bladder function in a rat model of chronic bladder ischemia. J Urol. 2013; 189(2): 754-61. https://doi.org/10.1016/j.juro.2012.07.141
    CROSSREF
  • 9.Aizawa N, Igawa Y, Nishizawa O, Wyndaele JJ. Effects of nitric oxide on the primary bladder afferent activities of the rat with and without intravesical acrolein treatment. Eur Urol. 2011; 59(2): 264-71. https://doi.org/10.1016/j.eururo.2010.10.035
    CROSSREF
  • 10.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. https://doi.org/10.1002/pros.22584
    CROSSREF
  • 11.Doroshyenko O, Fuhr U. Clinical pharmacokinetics and pharmacodynamics of solifenacin. Clin Pharmacokinet. 2009; 48(5): 281-302. https://doi.org/10.2165/00003088-200948050-00001
    CROSSREF
  • 12.Urakami S, Ogawa K, Oka S, et al. Effect of tadalafil add-on therapy in patients with persistant storage symptoms refractory to α(1) -adrenoceptor antagonist monotherapy for benign prostatic hyperplasia: A randomized pilot trial comparing tadalafil and solifenacin. Low Urin Tract Symptoms. 2019; 11(3): 109-14. https://doi.org/10.1111/luts.12242
    CROSSREF
  • 13.Barry MJ, Fowler FJ, Jr., O'Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992; 148(5): 1549-57; discussion 64. https://doi.org/10.1016/s0022-5347(17)36966-5
    CROSSREF
  • 14.Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997; 49(6): 822-30. https://doi.org/10.1016/s0090-4295(97)00238-0
    CROSSREF
  • 15.Rosen RC, Allen KR, Ni X, Araujo AB. Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol. 2011; 60(5): 1010-6. https://doi.org/10.1016/j.eururo.2011.07.053
    CROSSREF
  • 16.Turunc T, Deveci S, Güvel S, Peşkircioğlu L. The assessment of Turkish validation with 5 question version of International Index of Erectile Function (IIEF-5). Turk Uroloji Dergisi. 2007; 33: 45-9.
  • 17.Homma Y, Yoshida M, Seki N, et al. Symptom assessment tool for overactive bladder syndrome--overactive bladder symptom score. Urology. 2006; 68(2): 318-23. https://doi.org/10.1016/j.urology.2006.02.042
    CROSSREF
  • 18.Culha MG, Degirmentepe RB, Ozbir S, Cakir SS, Homma Y. Turkish validation of the overactive bladder symptom score (OABSS) and evaluation of mirabegron treatment response. Int Urogynecol J. 2019; 30(12): 2121-6. https://doi.org/10.1007/s00192-019-04054-0
    CROSSREF
  • 19.Yamaguchi O, Kakizaki H, Homma Y, et al. Solifenacin as add-on therapy for overactive bladder symptoms in men treated for lower urinary tract symptoms--ASSIST, randomized controlled study. Urology. 2011; 78(1): 126-33. https://doi.org/10.1016/j.urology.2011.02.055
    CROSSREF
  • 20.Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. 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(5): 917-25. https://doi.org/10.1016/j.eururo.2012.01.01
    CROSSREF
  • 21.Burnett AL, Maguire MP, Chamness SL, et al. Characterization and localization of nitric oxide synthase in the human prostate. Urology. 1995; 45(3): 435-9. https://doi.org/10.1016/S0090-4295(99)80012-0
    CROSSREF
  • 22.Yokoyama O, Yusup A, Oyama N, Aoki Y, Miwa Y, Akino H. Improvement in bladder storage function by tamsulosin depends on suppression of C-fiber urethral afferent activity in rats. J Urol. 2007; 177(2): 771-5. https://doi.org/10.1016/j.juro.2006.09.076
    CROSSREF
  • 23.Gong M, Dong W, Huang G, et al. Tamsulosin combined with solifenacin versus tamsulosin monotherapy for male lower urinary tract symptoms: a meta-analysis. Curr Med Res Opin. 2015; 31(9): 1781-92. https://doi.org/10.1185/03007995.2015.1074067
    CROSSREF
  • 24.Khan MA, Thompson CS, Dashwood MR, Mumtaz FH, Morgan RJ, Mikhailidis DP. Endothelin-1 and nitric oxide in the pathogenesis of urinary tract disorders secondary to bladder outlet obstruction. Curr Vasc Pharmacol. 2003; 1(1): 27-31. https://doi.org/10.2174/1570161033386600
    CROSSREF
  • 25.Chang S, Hypolite JA, Zderic SA, Wein AJ, Chacko S, Disanto ME. Increased corpus cavernosum smooth muscle tone associated with partial bladder outlet obstruction is mediated via Rho-kinase. Am J Physiol Regul Integr Comp Physiol. 2005; 289(4): R1124-30. https://doi.org/10.1152/ajpregu.00717.2003
    CROSSREF
  • 26.Schiff JD, Mulhall JP. The link between LUTS and ED: clinical and basic science evidence. J Androl. 2004; 25(4): 470-8. https://doi.org/10.1002/j.1939-4640.2004.tb02818.x
    CROSSREF
  • 27.Roehrborn CG, McVary KT, Elion-Mboussa A, Viktrup L. Tadalafil administered once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a dose finding study. J Urol. 2008; 180(4): 1228-34. https://doi.org/10.1016/j.juro.2008.06.079
    CROSSREF
  • 28.Roehrborn CG, Egan KB, Miner MM, Ni X, Wong DG, Rosen RC. Erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) combined responders to tadalafil after 12 weeks of treatment. BJU Int. 2016; 118(1): 153-60. https://doi.org/10.1111/bju.13406
    CROSSREF
  • 29.Liguori G, Trombetta C, De Giorgi G, et al. Efficacy and safety of combined oral therapy with tadalafil and alfuzosin: an integrated approach to the management of patients with lower urinary tract symptoms and erectile dysfunction. Preliminary report. J Sex Med. 2009; 6(2): 544-52. https://doi.org/10.1111/j.1743-6109.2008.01109.x
    CROSSREF
  • 30.Nieminen T, Tammela TL, Kööbi T, Kähönen M. The effects of tamsulosin and sildenafil in separate and combined regimens on detailed hemodynamics in patients with benign prostatic enlargement. J Urol. 2006; 176(6 Pt 1): 2551-6. https://doi.org/10.1016/j.juro.2006.07.154
    CROSSREF

Creative Commons

LİMRADIGITAL