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. 2020 Jun;8(2):78-84.
doi: 10.1016/j.prnil.2019.11.005. Epub 2020 Feb 25.

Improvement of the symptoms of lower urinary tract and sexual dysfunction with tadalafil and solifenacin after the treatment of benign prostatic hyperplasia with dutasteride

Kirill V Kosilov  1 , Irina G Kuzina  2 , Vladimir Kuznetsov  3 , Ekaterina K Kosilova  4
Affiliations

Improvement of the symptoms of lower urinary tract and sexual dysfunction with tadalafil and solifenacin after the treatment of benign prostatic hyperplasia with dutasteride

Kirill V Kosilov et al. Prostate Int. 2020 Jun.

Abstract

Background: The aim of this research is to study the influence of simultaneous taking of tadalafil and solifenacin in standard and double dosage on the lower urinary tract symptoms (LUTS) and sexual dysfunction in men with benign prostatic hyperplasia after the course of dutasteride.

Materials and methods: The research included 326 patients older than 50 years with benign prostatic hyperplasia coupled with LUTS and sexual dysfunction having undergone the course of treatment with dutasteride. After random division into three groups, patients from the Group A (n = 107) got tadalafil 5 mg/d as monotherapy, from the Group В (n = 107) got tadalafil 5 mg/d and solifenacin 10 mg/d, and from the Group С (n = 112) got tadalafil 5 mg/d and solifenacin 20 mg/d. The duration of treatment was 12 weeks. The rating of sexual function was made with the questionnaires International Index of Erectile Function and other.

Results: The results of rating of sexual function with the questionnaires MSHQ-EjD and International Index of Erectile Function correlated among themselves. According to MSHQ-EjD, overall rating of the sexual function increased in each of the three groups (A: 67.9 (12.4)/91.5 (10.4), P ≤ 0.05; B: 72.4 (14.5)/102.6 (16.9), P ≤ 0.05; C: 76.6 (16.3)/109.6 (15.6), P ≤ 0.05). The level of hyperactivity symptoms decreased in Groups В and С (В: urgency -2.9 (0.7)/1.1 (0.6), P ≤ 0.05; nocturia 2.7 (1.0)/0.7 (0.5), P ≤ 0.05; C: urgency -2.5 (0.5)/0.8 (0.6), P ≤ 0.05; nocturia -2.8 (0.6)/1.0 (0.5), P ≤ 0.05), and it did not change in the Group A.

Conclusions: The use of tadalafil as monotherapy significantly improves the sexual function but does not affect overactive bladder symptoms. The combination therapy of tadalafil and solifenacin leads to dramatic improvement of sexual function and reversibility of detrusor hyperactivity symptoms.

Keywords: Benign prostatic hyperplasia; Dutasteride; Lower urinary tract symptoms; Sexual dysfunction; Solifenacin; Tadalafil.

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Conflict of interest statement

All authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Changes in indicators of Men's Sexual Health Questionnaire in men with benign prostatic hyperplasia and lower urinary tract symptoms, who received combined treatment by dutasteride and solifenacin. Group A (N = 107)—acceptance of tadalafil 5 mg/d; Group B (N = 107)—acceptance of tadalafil 5 mg/d and solifenacin 10 mg/d; and Group C (N = 112)—acceptance of tadalafil 5 mg/d and solifenacin 20 mg/d.
Fig. 2
Fig. 2
Percentage of patients without symptoms of hyperactivity of the LUT in the 3-month course of treatment of the combinations by tadalafil and solifenacin. Group A (N = 107)—acceptance of tadalafil 5 mg/d; Group B (N = 107)—acceptance of tadalafil 5 mg/d and solifenacin 10 mg/d; Group C (N = 112)—acceptance of tadalafil 5 mg/d and solifenacin 20 mg/d. LUT, lower urinary tract.
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