Battle of the Blends: Evaluating Tamsulosin-dutasteride and Silodosindutasteride in Benign Prostatic Hyperplasia Patients

Introduction: Benign Prostatic Hyperplasia (BPH) significantly contributes to lower urinary tract symptoms (LUTS), adversely affecting quality of life (QoL). This study aims to compare symptomatic improvement and QoL in patients receiving Silodosin and Dutasteride versus Tamsulosin and Dutasteride, utilizing the International Prostate Symptom Score (IPSS) and IPSS QoL score. Methods: A prospective observational study was conducted at the outpatient department of Urology, Government Medical College, Kozhikode, over six months, with institutional ethics approval. Patients were assigned to receive either Silodosin 8 mg + Dutasteride 0.5 mg or Tamsulosin 0.4 mg + Dutasteride 0.5 mg. Symptomatic improvement and QoL were assessed using the IPSS and IPSS QoL questionnaire. Uroflowmetric data, including Qmax and Qave, were collected. Adverse drug events were monitored. Data analysis was performed using SPSS, with p < 0.05 considered statistically significant. Results: Ninety-seven subjects were enrolled: 46 on Tamsulosin + Dutasteride and 51 on Silodosin + Dutasteride. Significant reductions in IPSS scores and improvements in QoL were observed in the Silodosin group compared to the Tamsulosin group (p < 0.05). Both groups showed comparable improvements in Qmax and Qave. Both treatment combinations exhibited high tolerability, with mild adverse effects such as dizziness, postural hypotension, and ejaculation disorders reported infrequently. Discussion: The present study found that Silodosin + Dutasteride provided greater improvement in IPSS reduction, QoL scores, and Qmax compared to Tamsulosin + Dutasteride, with fewer adverse effects. Although statistical significance was not observed for Qmax changes, Silodosin + Dutasteride demonstrated superior efficacy and safety, enhancing quality of life for BPH patients over 6 months. Conclusion: Silodosin combined with Dutasteride is more effective than Tamsulosin combined with Dutasteride in reducing IPSS scores and enhancing QoL over six months. Both regimens demonstrated comparable efficacy in improving urinary flow rates, with a favorable safety profile.