Re: Efficacy of tadalafil treatment in erectile dysfunction in patients receiving dutasteride treatment: A prospective nonrandomized comparative study
Abstract
Available online at turkishjournalofurology.com Apart from erectile dysfunction treatment, phosphodiesterase-5 inhibitors are being commonly used in the treatment of lower urinary tract symptoms (LUTS) that are secondary to benign enlargement of prostate. This study demonstrated the beneficial effects of tadalafil treatment in terms of improvement in erection and probably LUTS.[1,2] The pharmacology of LUTS aims to address obstructive and storage symptoms. The available medical treatment options include α1-adrenergic blocker, antimuscarinics, β3 agonist, 5α-reductase inhibitors, and phosphodiesterase-5 inhibitors. For obstructive symptoms, α1-blockers or PDE5 inhibitors provide immediate relief, whereas 5α-reductase inhibitors may take 3–6 months to provide symptomatic relief, and 5α-reductase inhibitors reduces prostatic growth, which reduces the prostate volume by 25%–50% by 6 months.[3] For storage/voiding symptoms, the mainstay of treatment includes antimuscarinics and β3-adrenoceptor agonists. In this study, it is not clear why α1-adrenoceptors blockers were not used with 5α reductase inhibitors for quick relief of symptoms. The medications used for LUTS affect sexual function, which includes erection, ejaculation, orgasm/ climax, and libido. In combat study, sexual dysfunctions were more with combination therapy and the same trend was noted for erectile dysfunction; 9% of the patients who received combination therapy (Tamsulosin plus dutasteride) had erectile…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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