Urodynamic effects of once-daily tadalafil in men with LUTS secondary to clinical BPH

Lower urinary tract symptoms (LUTS) are common and increase with age in men with benign prostatic hypertrophy (BPH). Erectile dysfunction (ED) also increases with age and is often a comorbid condition with BPH. Treatment with phosphodiesterase type 5 (PDE5) inhibitors aimed at decreasing breakdown of nitric oxide (NO) is a mainstay of treatment for ED. Because NO has been found to mediate male prostatic and urinary function in multiple ways, there is increasing interest in PDE5 inhibitors addressing concomitant LUTS. Several studies have shown significant improvement in LUTS after treatment with PDE5 inhibitors; however, concern exists that PDE5 inhibitors exert their beneficial effects through impairment of bladder function. Because limited invasive urodynamic data exist to address these queries, tadalafil's impact on bladder function was recently evaluated. Results indicate that tadalafil treatment had no negative impact on bladder function, as measured by detrusor pressure at maximum flow or any other urodynamic parameter assessed.