Background: Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting middle-aged men. This condition can be symptomatic or asymptomatic. Up to 15-25% of men aged 50-65 years have lower urinary tract symptoms (LUTS). Aim of the Work: To compare between the effect of alpha blocker (Tamsulosin 0.4 mg once at night) and a combination of alpha blockers (Tamsulosin 0.4 mg once at morning) and PDE5 inhibitors (Sildenafil 25 mg at night) in treatment of benign prostatic hyperplasia patients through evaluation of IPSS and post-voiding residual urine and uroflometry before and after treatment. Patients and Methods: This was a prospective study done on 30 patients fulfilling inclusion criteria at Eldemerdash hospital between 1-9-2017 till 1-9-2018 and this study has two phases: Phase (1): included 30 patients complaining of LUTS 2ry to BPH assessed by uroflowmetry and IPSS and post voiding residual urine.
Before taking any drugs and after treatment by alpha blocker (tamsulosin 0.4mg capsule once daily at night) for 3 months. Phase (2): included the same 30 patients after treatment by phase (2) of alpha blocker (Tamsulosin 0.4 capsule once daily in the morning) and PDEI (sildenafil 25mg once daily in the night) for 3 months. These patient also assessed by IPSS, uroflowmetry and PVR urine. Results: The results of this study showed that there was a significant improvement after phase 1 treatment in IPSS, also there was a significant improvement after phase 2 more than phase 1. The PVRU and Q max was significantly improve after phase 1 but the change after phase 2 was insignificant. Conclusion: Sildenafil citrate in combination with tamsulosin improved LUTS more than tamsulosin monotherapy with the merit of a comparable safety profile in patients with LUTS/BPH.