الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 122 |  |  |
| | | from | 122 | | |
Abstract
B
enign prostatic hyperplasia (BPH) is defined as the proliferation of prostatic stromal cells, which results in an enlarged prostate gland. As a result, the prostatic urethra is compressed, which restricts the flow of urine from the bladder.
BPH is relatively common in men and symptoms can start as early as age 30. By the age of 50, up to 50% of men exhibit histologic evidence of BPH symptoms and these symptoms tend to increase with age.
BPH symptoms are generally referred to as ”Lower urinary tract symptoms” or LUTS, and these can be subdivided into voiding symptoms and storage symptoms. Voiding symptoms include hesitancy, intermittency, straining, dribbling, and the decreased caliber of the urine stream. Storage symptoms include frequency, urgency, and nocturia. The severity of BPH can be measured by using the International Prostate Symptom Score (IPSS) questionnaire.
Variable treatment options are available for treatment of patients with benign prostatic hyperplasia (BPH) ranging from watchful waiting, Pharmacological therapy, minimally invasive to invasive therapy. Pharmacological therapy include, alpha blockers, 5 alpha-reductase inhibitors and phytotherapy.
In our analysis the aim of this study is 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.
This is a prospective randomized clinical study including 30 patient with BPH/LUTS, 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 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.
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.