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Meta-Analysis
. 2025 May 11;43(1):291.
doi: 10.1007/s00345-025-05662-w.

Tamsulosin plus Tadalafil compared with Tamsulosin alone for benign prostate hyperplasia in patients with or without erectile dysfunction: a meta-analysis and meta-regression of randomized controlled trials

Tallal Mushtaq Hashmi  1 , Rohma Zia  1 , Hadiah Ashraf  1 , Momina Siddiqui  1 , Ali Haider  1 , Valencia Rumampouw  2 , Momina Aslam Khan  3 , Mushood Ahmed  1 , Javed Iqbal  4
Affiliations
Meta-Analysis

Tamsulosin plus Tadalafil compared with Tamsulosin alone for benign prostate hyperplasia in patients with or without erectile dysfunction: a meta-analysis and meta-regression of randomized controlled trials

Tallal Mushtaq Hashmi et al. World J Urol. .

Abstract

Background: Combination pharmacotherapy with tamsulosin plus tadalafil could be a superior strategy compared to conventional monotherapy with tamsulosin in patients with Benign prostatic obstruction (BPO) with or without erectile dysfunction.

Methodology: A comprehensive search was conducted across PubMed, the Cochrane Library, and Embase to identify studies assessing the efficacy and safety of combination therapy compared with monotherapy in patients with BPO with or without erectile dysfunction. A random effects meta-analysis was performed with R version 4.4.1 using the 'meta' package.

Results: We included eleven RCTs, with a combined total of 940 patients. Our analysis demonstrated that the combination therapy is associated with a greater reduction in overall IPSS (MD = - 2.78, 95% CI - 3.97 to - 1.59; P < 0.01), IIEF (MD = 2.98, 95% CI 1.64 to 4.33; P < 0.01), QoL score (MD = - 0.58, 95% CI - 0.86 to - 0.30; P < 0.01), PVR (MD = - 9.34, 95% CI = -15.52 to - 3.16; P < 0.01) and a significant improvement in Qmax (MD = 1.04, 95% CI 0.43 to 1.64; P < 0.01) as compared to tamsulosin alone. However, combination therapy resulted in a higher incidence of pain (OR = 5.66, 95% CI 2.56 to 12.52; P < 0.01) and other adverse events (OR = 2.97, 95% CI 1.60 to 5.49; P < 0.01).

Conclusion: Combination therapy with tamsulosin and tadalafil demonstrated superior efficacy over tamsulosin monotherapy in reducing LUTS, improving quality of life, and enhancing erectile function. However, it was associated with a higher incidence of adverse effects.

Keywords: Benign prostatic hyperplasia; Erectile dysfunction; Meta-analysis; Tadalafil; Tamsulosin.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: No ethical approval was required for the study. Consent: No consent was needed.

Figures

Fig. 1
Fig. 1
PRISMA flowchart depicting the screening and study selection process
Fig. 2
Fig. 2
Forest plot showing changes from baseline in A Overall IPSS, B IIEF, C QoL
Fig. 3
Fig. 3
Forest plots depicting change in A PVR, B Qmax
Fig. 4
Fig. 4
Forest plots for A Any pain, B Adverse events
See this image and copyright information in PMC

References

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