The FDA has approved tadalafil (TDL) for the treatment of benign prostatic hyperplasia (BPH)-associated symptoms. Pumpkin seed oil (PSO) has shown promise for the relief of prostatitis-related lower urinary tract symptoms. The aim was to improve TDL delivery to the prostate and assess the combined effect of TDL with a PSO-based formula in the management of BPH. PSO, Tween 80, and polyethylene glycol 200 were selected for the optimization of self nano-emulsified drug delivery system (SNEDDS). The formed vesicles were assessed for their globule size and zeta potential. A rat in vivo study was carried out to investigate prostate weight and index, histopathology, and pharmacokinetics. The average globule size for the optimized TDL-PSO SNEDDS was 204.8 ± 18.76 nm, with a zeta-potential value of 7.86 ± 1.21 mV. TDL-PSO SNEDDS produced a marked drop in prostate weight by 35.51% and prostate index by 36.71% compared to the testosterone-only group. Pharmacokinetic data revealed a 2.3-fold increase of TDL concentration, from optimized TDL-PSO SNEDDS, in the prostate compared with the raw TDL group. This study indicated that the combination of TDL and PSO in an optimized TDL PSO SNEDDS formula improved the efficacy of TDL in the management of BPH.Pharmaceutics 2019, 11, 640 2 of 13 PDE5 also elevates the amount of blood reaching the lower urinary tract, while influencing the afferent nerve activity of the bladder [5,9,10]. Moreover, bladder performance can be impacted by functional and structural variations in the prostate, bladder, and the vasculature supporting such structures [11]. This elevation in cGMP concentration results in an efflux of calcium and relaxation of the SMCs. Several processes may aid in the alleviation of lower urinary tract symptoms (LUTS) and can be facilitated by PDE5 isoenzyme inhibition in the lower part of the urinary tract [4]. Altogether, the administration of 5 mg of tadalafil (TDL) in a daily manner led to significantly better results compared to the placebo. The safety profile of TDL was promising, and TDL was found to be well-tolerated [1,12]. Thus, the findings of these studies supported administering TDL 5 mg once a day as a treatment for benign LUTS suggestive of BPH [1,12,13]. TDL (5 mg) was approved by the FDA to be taken once a day for the treatment of LUTS symptoms linked to BPH. A randomized, double-blind, placebo-controlled, parallel design study using 2.5 mg of TDL over 12 weeks indicated improvements in the international prostate symptom score (IPSS) [14]. TDL increased pelvic perfusion by up-regulating NO and cGMP, which reduced the prostatic ischemia and improved the blood circulation.Pumpkin seed oil (PSO) is a part of the Cucurbitaceae family that has demonstrated excellent potential for the treatment of nocturia, urinary incontinence, and the frequency of urination in clinical trials [9]. PSO's chemical composition includes fatty acids, tocopherols, and phytosterols, in addition to squalene (triterpene). The main fatty acids that constitute about 90% of PSOs are palmitic aci...