Tadalafil 5 mgs once daily has been approved by the FDA (Food and Drug Administration) for the treatment of BPH (benign prostatic hyperplasia) signs and symptoms - a condition in which the prostate gland enlarges. It has also been approved for the treatment of simultaneous BPH and erectile dysfunction.
Benign prostatic hyperplasia (BPH), refers to an increase in the size of the prostate gland. Signs and symptoms can include difficulty in starting urination, a weakened urine flow which causes stopping and starting, strain when passing urine, urinating too frequently, waking up in the night often to urinate (Nocturia), sudden urges to urinate which can result in incontinence if a toilet is not found immediately, inability to fully empty the bladder during urination, and sometimes blood in urine.
Normal prostate on left, Benign prostatic hyperplasia on right
IPSS (International Prostate Symptom Score) is commonly used to measure BPH severity of symptoms. Two human studies demonstrated that patients with BPH who were prescribed 5 mg of tadalafil once a day had statistically significant improvements in BPH symptoms compared to those on a placebo. The findings were based on lower total IPSS scores.
Another study reviewed by the FDA showed that males with both BPH and ED combined who were given 5 mg of tadalafil had improvements in both conditions, compared to those in the placebo group. ED symptom improvements were measured using the Erectile Function domain score of the International Index of Erectile Function.
Benign prostatic hyperplasia (BPH), refers to an increase in the size of the prostate gland. Signs and symptoms can include difficulty in starting urination, a weakened urine flow which causes stopping and starting, strain when passing urine, urinating too frequently, waking up in the night often to urinate (Nocturia), sudden urges to urinate which can result in incontinence if a toilet is not found immediately, inability to fully empty the bladder during urination, and sometimes blood in urine.
Normal prostate on left, Benign prostatic hyperplasia on right
IPSS (International Prostate Symptom Score) is commonly used to measure BPH severity of symptoms. Two human studies demonstrated that patients with BPH who were prescribed 5 mg of tadalafil once a day had statistically significant improvements in BPH symptoms compared to those on a placebo. The findings were based on lower total IPSS scores.
Another study reviewed by the FDA showed that males with both BPH and ED combined who were given 5 mg of tadalafil had improvements in both conditions, compared to those in the placebo group. ED symptom improvements were measured using the Erectile Function domain score of the International Index of Erectile Function.
Tadalafil:
It is a PDE -5 inhibitor and works by preventing the degradation of cyclic GMP.The pent up cyclic GMP leads to dilatation of vasculature and hence good sustenance of erection.
Tadalafil has a longer duration of action( t half 17.50 hours) compared to sildenafil ( 4-5 hours).This attribute of the tadalafil can be exploited by giving the medication daily and helping to cure the vasculature of the penis .( vascular remodeling)..................................
BPH AND ERECTILE DYSFUNCTION:
The basic pathophysiological reason why tadalafil helps in BPH is the symptoms of BPH are prostatic obstruction.This obstruction leads to detrusor hypertrophy and detrusor ischemia.
The ischemia of the bladder wall is directly proportional to the intensity of obstruction. So any drug which causes the reversal of the ischemia can alleviate the lower urinary tract symptoms also.
30% patients with BPH have metabolic syndrome- hypertension, deranged cholesterol levels, obesity, hyperuricemia etc. The metabolic syndrome and erectile dysfunction goes often hand in hand as the metabolic syndrome can cause endothelial dysfunction which in turn lead to sexual dysfunction. The patients also have coexisting coronary artery disease and low effort tolerance. Proper precaution need to be taken in these patients when both alpha blockers and tadalafil is given together as these two can lead to drop in BP.The titrated dosage can prevent any such catastrophic sequel.
30% patients with BPH have metabolic syndrome- hypertension, deranged cholesterol levels, obesity, hyperuricemia etc. The metabolic syndrome and erectile dysfunction goes often hand in hand as the metabolic syndrome can cause endothelial dysfunction which in turn lead to sexual dysfunction. The patients also have coexisting coronary artery disease and low effort tolerance. Proper precaution need to be taken in these patients when both alpha blockers and tadalafil is given together as these two can lead to drop in BP.The titrated dosage can prevent any such catastrophic sequel.
The tadalafil in low dosage can take care of both erectile dysfunction and obstructive lower urinary symptoms.
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