COMPARISON OF EFFICACY OF PDE5 INHIBITORS (SILDENAFIL) VERSUS ALPHA-BLOCKERS (TAMSULOSIN) IN TREATMENT OF LOWER URINARY TRACT SYMPTOMS (LUTS) SECONDARY TO BENIGN PROSTATIC HYPERPLASIA

Benign prostatic hyperplasia (BPH) is a prevalent condition leading to lower urinary tract symptoms (LUTS) in men, affecting their quality of life. Various medications, including phosphodiesterase five inhibitors (PDE5-Is) and alpha-blockers (ABs), are used for treatment, but direct comparison studies between these drugs are limited. This study aimed to compare the efficacy of sildenafil (PDE5 inhibitor) versus tamsulosin (alpha-blocker) in patients with LUTS secondary to BPH. A randomized controlled trial was conducted at the Department of Urology, KEMU/Affiliated Hospital, Lahore. A sample size of 100 patients (50 in each group) was calculated using the WHO calculator based on expected efficacy rates. Patients aged 40-70 years with BPH and LUTS were included. Exclusion criteria included high PSA levels, history of prostatic surgery, acute urinary retention, or active urinary tract infection. Patients were randomly assigned to receive sildenafil 25mg OD or tamsulosin 0.4mg HS for three months. Efficacy was assessed by changes in the International Prostate Symptom Score (IPSS) after treatment. The demographic characteristics of the study population showed a mean age of 60 years with a similar distribution of comorbidities between the groups. After three months of treatment, 80.9% of patients in the sildenafil group showed a significant improvement in IPSS compared to 55.5% in the tamsulosin group. The chi-square test indicated a significant difference in efficacy between the two groups (p < 0.05). Sildenafil demonstrated superior efficacy compared to tamsulosin in reducing LUTS secondary to BPH. These findings suggest that sildenafil may be considered as a first-line treatment option for patients with BPH and LUTS.