The Effects of Tamsulosin and Sildenafil in Separate and Combined Regimens on Detailed Hemodynamics in Patients With Benign Prostatic Enlargement

No AccessJournal of UrologyAdult urology1 Dec 2006The Effects of Tamsulosin and Sildenafil in Separate and Combined Regimens on Detailed Hemodynamics in Patients With Benign Prostatic Enlargement Tuomo Nieminen, Teuvo L.J. Tammela, Tiit Kööbi, and Mika Kähönen Tuomo NieminenTuomo Nieminen Department of Pharmacological Sciences, Medical School, University of Tampere, Tampere, Finland , Teuvo L.J. TammelaTeuvo L.J. Tammela Department of Urology, Medical School, University of Tampere, Tampere, Finland Tampere University Hospital, Tampere, Finland , Tiit KööbiTiit Kööbi Department of Clinical Physiology, Medical School, University of Tampere, Tampere, Finland Tampere University Hospital, Tampere, Finland , and Mika KähönenMika Kähönen Department of Clinical Physiology, Medical School, University of Tampere, Tampere, Finland Tampere University Hospital, Tampere, Finland View All Author Informationhttps://doi.org/10.1016/j.juro.2006.07.154AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We measured the detailed hemodynamic effects of tamsulosin and sildenafil separately and together in patients with benign prostatic enlargement. Materials and Methods: The supine effects of and responses to passive orthostasis (60 degrees for 8 minutes) were measured in 16 patients with benign prostatic enlargement with the finger blood pressure method and whole-body impedance cardiography. The medications, 100 mg sildenafil (single doses) and 0.4 mg tamsulosin (once daily for up to 14 days), were administered in a randomized, double-blind, crossover fashion. Results: Supine systolic arterial pressure decreased with sildenafil (mean ± SEM −11 ± 2 mm Hg) and sildenafil plus tamsulosin (−14 ± 2 mm Hg) more than with placebo (−2 ± 4 mm Hg, p <0.05). In comparison to placebo sildenafil plus tamsulosin decreased the systemic vascular resistance index (328 ± 129 vs −241 ± 134 dyn·sec/cm5·m2, p = 0.01). Tamsulosin alone did not cause any significant changes in comparison to placebo. Heart rate, diastolic arterial pressure, stroke index, cardiac index and arterial pulse wave velocity were not affected to a statistically significant degree by any of the treatments compared to placebo. Upon head-up tilt the drugs caused only 1 significant change in that diastolic arterial pressure was significantly higher (−2.7 vs −8.0 mm Hg, p = 0.04) in the placebo group than in the tamsulosin plus sildenafil group. Conclusions: Tamsulosin does not disturb hemodynamics in patients with benign prostatic enlargement. Sildenafil decreases blood pressure with the patient supine but not during head-up tilt. The combination treatment also decreases the systemic vascular resistance index in the supine position. References 1 : α1-Adrenergic receptors and their inhibitors in lower urinary tract symptoms and benign prostatic hyperplasia. J Urol2004; 171: 1029. Link, Google Scholar 2 : Phosphodiesterase type 5 (PDE5) inhibitors. Prog Med Chem2003; 41: 249. 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Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetails Volume 176Issue 6December 2006Page: 2551-2556 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsphosphodiesterase inhibitorssupine positionadrenergic antagonistsadrenergic alpha-antagoniststilt-table testAcknowledgmentsPirjo Järventausta, study nurse, provided skillful technical assistance.MetricsAuthor Information Tuomo Nieminen Department of Pharmacological Sciences, Medical School, University of Tampere, Tampere, Finland More articles by this author Teuvo L.J. Tammela Department of Urology, Medical School, University of Tampere, Tampere, Finland Tampere University Hospital, Tampere, Finland More articles by this author Tiit Kööbi Department of Clinical Physiology, Medical School, University of Tampere, Tampere, Finland Tampere University Hospital, Tampere, Finland More articles by this author Mika Kähönen Department of Clinical Physiology, Medical School, University of Tampere, Tampere, Finland Tampere University Hospital, Tampere, Finland More articles by this author Expand All Advertisement PDF downloadLoading ...