Dear S.V. Krishna Reddy,

Monotherapy with tadalafil or tamsulosin resulted in significant and numerically similar improvements versus placebo in LUTS/BPH and Q(max). Therefore, either one can be used. For more details, see the following publication:

Abstract

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Eur Urol. 2012 May;61(5):917-25. doi: 10.1016/j.eururo.2012.01.013. Epub 2012 Jan 20.

Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomised, parallel, placebo-controlled clinical trial.

Oelke M1, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L.

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Abstract

BACKGROUND:

Tadalafil improved lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH; LUTS/BPH) in clinical studies but has not been evaluated together with an active control in an international clinical study.

OBJECTIVE:

Assess tadalafil or tamsulosin versus placebo for LUTS/BPH.

DESIGN, SETTING, AND PARTICIPANTS:

A randomised, double-blind, international, placebo-controlled, parallel-group study assessed men ≥45 yr of age with LUTS/BPH, International Prostate Symptom Score (IPSS) ≥13, and maximum urinary flow rate (Q(max)) ≥4 to ≤15ml/s. Following screening and washout, if needed, subjects completed a 4-wk placebo run-in before randomisation to placebo (n=172), tadalafil 5mg (n=171), or tamsulosin 0.4mg (n=168) once daily for 12 wk.

MEASUREMENTS:

Outcomes were assessed using analysis of covariance (ANCOVA) or ranked analysis of variance (ANOVA) (continuous variables) and Cochran-Mantel-Haenszel test or Fisher exact test (categorical variables).

RESULTS AND LIMITATIONS:

IPSS significantly improved versus placebo through 12 wk with tadalafil (-2.1; p=0.001; primary efficacy outcome) and tamsulosin (-1.5; p=0.023) and as early as 1 wk (tadalafil and tamsulosin both -1.5; p

Well in my 40years of work in urology i had the impression that the efficiency of my medication was always so good as the patient believed in it. That' s why i remained in uro-surgery Your Hainz

The first commonly used monotherapies included selective alpha blockers (AB) and 5-alpha reductase inhibitors (5-ARIs) (Table 1). The American Urological Association (AUA) guideline on the management of BPH suggests that alpha blockers alfuzosin, doxazosin, tamsulosin, and terazosin are appropriate and effective treatment options for men with bothersome LUTS/BPH.7 Efficacy and safety of these medications is supported by several systematic reviews.8-12 Due to the potential serious adverse effect of floppy iris syndrome, men should be asked about planned cataract surgery and be counseled to delay AB treatment until after such surgery.7

Monotherapy with 5-ARI agents finasteride and dutasteride is another option for LUTS/BPH and BPE.7 Systematic reviews demonstrate that 5-ARIs are safe and effective13,14 and may be better than ABs in preventing disease progression (acute urinary retention and/or the need for surgical intervention). 

For more plz read at following link.

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http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=2067

Selective alfa blockers are the most important monotherapy in LUTS duo to BPH.in patients with BPH and imptence comorbity ,tadalafil was showen effective .

Alfa blockers are the first line mono-therapy in LUTS secondary to BPH. 

Selective alfa blochkers indicated for monotherapy LUTS on the basis of BPH.

I hope that following article will help you

Article Re: Monotherapy with Tadalafil or Tamsulosin Similarly Impro...

alpha blockers that act on Alpha 1d will give more response for bothering storage symptoms. while the group of alpha 1a will improve voiding symptoms more.

As per findings from a vast majority of research, Both BPH and ED can effectively treated with tadalafil despite, hypotension as side effect is highly associated with this drug.

Teupolioside, a phenylpropanoid glycosides of Ajuga reptans, biotechnologically produced by plant cell line showed unprecedented results in terms of lower LUTS, IPSS and IIEF scores. Inhibits conversion of testosterone in DHT (acts as 5ARI). Acts at anti-inflammatory level (lowers oxidative stress expressed in Carratelli units with FRAS method). No side effects.

Registry study available for formula licensing.

There are several herbal remedies, but the most effective are alpha blockers and, in some cases, anticholinergics.