title: Urodynamic effects of the combination of tamsulosin and daily tadalafil in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: a randomized, placebo-controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the effect of association of tamsulosin/tadalafil taken daily compared with tamsulosin/placebo in the lower urinary tract with urodynamic study (UDS).
  
  
  METHODS
  All patients underwent baseline UDS before randomization to tamsulosin 0.4 mg/tadalafil 5 mg (Group 1; n = 20) or tamsulosin 0.4 mg/placebo (Group 2; n = 20) once daily for 30 days. End-of-study UDS were performed on completion of the treatment period. The primary end point was to demonstrate changes in urodynamic variables in the voiding phase, detrusor pressure at maximum flow (PdetQmax), and maximum flow rate (Qmax), from baseline to week four.
  
  
  RESULTS
  The primary outcome measure of this clinical trial, PdetQmax, showed a significant reduction in tamsulosin/tadalafil group (13 ± 17.0) compared to tamsulosin/placebo (-1.2 ± 14.35) group (P = 0.03). Qmax increased in both groups, tamsulosin/tadalafil (1.0 ± 2.4) and tamsulosin/placebo (1.4 ± 2.4), but the difference was not significant between treatment groups (P = 0.65). Total IPSS, storage, and voiding sub-score improved significantly in tamsulosin/tadalafil compared with tamsulosin/placebo group.
  
  
  CONCLUSIONS
  The association of tamsulosin/tadalafil reduces detrusor pressure at maximum flow without changing the maximum flow rate during micturition and significantly improves lower urinary tract symptoms compared with the isolated use of tamsulosin.
authors.affiliation: Division of Urology, Universidade Federal do Ceara, 280, Antonele Bezerra st. Ap 1501, Meireles, Fortaleza, Ceara 60160-070, Brazil.
authors.forename: Rommel Prata
authors.initials: RP
authors.lastname: Regadas
authors.forename: Ricardo
authors.initials: R
authors.lastname: Reges
authors.forename: João Batista Gadelha
authors.initials: JB
authors.lastname: Cerqueira
authors.forename: Daniel Gabrielle
authors.initials: DG
authors.lastname: Sucupira
authors.forename: Iatagan Rocha
authors.initials: IR
authors.lastname: Josino
authors.forename: Emmanuel Almeida
authors.initials: EA
authors.lastname: Nogueira
authors.forename: Francisco Vagnaldo F
authors.initials: FV
authors.lastname: Jamacaru
authors.forename: Manoel Odorico
authors.initials: MO
authors.lastname: de Moraes
authors.forename: Lúcio Flávio Gonzaga
authors.initials: LF
authors.lastname: Silva
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D002243:Carbolines / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D011470:Prostatic Hyperplasia / Q000150:complications; D053448:Prostatism / Q000188:drug therapy* / Q000209:etiology; D013449:Sulfonamides / Q000494:pharmacology*; D000068581:Tadalafil; D000077409:Tamsulosin; D053201:Urinary Bladder, Overactive / Q000188:drug therapy; D014554:Urination / Q000187:drug effects / Q000502:physiology; D014563:Urodynamics / Q000187:drug effects*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D002243:Carbolines; D058986:Phosphodiesterase 5 Inhibitors; D013449:Sulfonamides; D000068581:Tadalafil; D000077409:Tamsulosin