Combination Therapy with Tadalafil and Tamsulosin Enhances LUTS Outcomes but Increases Side Effects

A meta-analysis of 12 randomized controlled trials involving 1,531 patients has demonstrated that combination therapy with tadalafil and tamsulosin is more effective than monotherapy for managing lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH), with or without erectile dysfunction (ED). However, this combined approach also leads to higher rates of adverse effects.

The analysis revealed significant improvements in the total International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and quality of life (QoL) for patients receiving combination therapy compared to monotherapy. 

Specifically, the combined treatment enhanced IPSS voiding scores and reduced postvoid residual urine (PVR) more effectively than tamsulosin alone, although PVR outcomes were similar to tadalafil monotherapy.

In terms of erectile function, measured by the International Index of Erectile Function (IIEF), the combined therapy outperformed tamsulosin but did not show additional benefits over tadalafil alone. Importantly, while no serious adverse events were reported, the incidence of minor side effects was higher in the combination therapy group than in the monotherapy groups.

These findings suggest that tadalafil and tamsulosin combination therapy provides superior outcomes for LUTS/BPH management, though its benefits for ED are less clear. Clinicians should weigh these advantages against the increased likelihood of mild adverse effects when considering combination treatment for their patients.