Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and ...Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.展开更多
The long-term safety and effectiveness of once-daily tadalafil is crucial,but limited data are available in Chinese patients witherectile dysfunction(ED).In this post-marketing,multicenter,randomized,open-label trial ...The long-term safety and effectiveness of once-daily tadalafil is crucial,but limited data are available in Chinese patients witherectile dysfunction(ED).In this post-marketing,multicenter,randomized,open-label trial with 2-year follow-up,635 ED caseswere randomized to receive daily oral tadalafil 2.5 mg or 5 mg for 3 months,of whom 580 continued once-daily tadalafil 5 mg for21 months.Treatment-emergent adverse events in the 12-month and 24-month period were similar,with the most common beingviral upper respiratory tract infection,upper respiratory tract infection,and headache.Significant improvement from baseline inthe International Index of Erectile Function-Erectile Function(IIEF-EF)score was detected at month 12(least squares mean[LSM]change:7.9,95%confidence interval[CI]:7.5–8.4,P<0.001)and was maintained to month 24(LSM change:8.6,95%CI:8.1–9.0,P<0.001).The proportions of patients regaining normal erectile function(IIEF-EF score≥26)were 43.7%and 48.0%at months 12 and 24,respectively.Global Assessment Questionnaire results showed improved erection function in 97.5%ofpatients and improved ability to engage in sexual activity in 95.9%of patients at month 12;these values were 96.1%and 95.0%at month 24,respectively.The quality of sexual life score based on the Sexual Life Quality Questionnaire(SLQQ)was increased by52.2%at month 12 and by 55.3%at month 24(both P<0.001).The treatment satisfaction score determined by SLQQ(mean±standard deviation)was 62.4±21.0 at month 12 versus 65.9±20.2 at month 24.Two-year daily application of tadalafil 5mg in Chinese men with ED showed a favorable safety profile and durable improvement in sexual performance and satisfaction.展开更多
Objective: According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by...Objective: According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.Methods: In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.Results: Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05).Conclusion: Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.展开更多
A highly sensitive liquid chromatography-tandem mass spectrometry（LC-MS/MS） method was developed for the determination of tadalafil（TAD） in human plasma. TAD and its deuterated internal standard（IS）, tadalafil-d...A highly sensitive liquid chromatography-tandem mass spectrometry（LC-MS/MS） method was developed for the determination of tadalafil（TAD） in human plasma. TAD and its deuterated internal standard（IS）, tadalafil-d3, were extracted from 200 mL plasma using Phenomenex Strata-X-C 33 m extraction cartridges. Chromatographic analysis was carried out on Synergi Hydro-RP C18（100 mm × 4.6 mm, 4 mm）column with a mobile phase consisting of methanol and 10 m M ammonium formate, p H 4.0（90：10, v/v）,delivered at a flow rate of 0.9 m L/min. Quantitation of the protonated analyte was done on a triple quadrupole mass spectrometer using multiple reaction monitoring via electrospray ionization. The precursor to product ions transitions monitored for TAD and TAD-d3 were m/z 390.3-268.2 and m/z393.1-271.2, respectively. The calibration curve was linear over the concentration range of 0.50–500 ng/m L with correlation coefficient, r2 Z 0.9994. Acceptable intra-batch and inter-batch precision（r3.7%） and accuracy（97.8% to 104.1%） were obtained at five concentration levels. The recovery of TAD from spiked plasma was highly precise and quantitative（98.95% to 100.61%）. Further, the effect of endogenous matrix components was minimal. TAD was found to be stable under different storage conditions in human plasma and also in whole blood samples. The validated method was successfully used to determine TAD plasma concentration in a bioequivalence study with 20 mg TAD tablets in 24 healthy volunteers. Method performance was evaluated by reanalyzing 115 study samples.展开更多
Aim： To assess the efficacy and safety of tadalafil in comparison to a placebo, when taken on demand for 12 weeks by East/Southeast Asian men with erectile dysfunction （ED）, Methods： This multicenter, randomized, ...Aim： To assess the efficacy and safety of tadalafil in comparison to a placebo, when taken on demand for 12 weeks by East/Southeast Asian men with erectile dysfunction （ED）, Methods： This multicenter, randomized, double-blind, parallel group, placebo-controlled study was conducted at 17 centers across East and Southeast Asia between August 2002 and February 2003. Men more than 18 years of age with mild to severe ED of various etiologies were randomized to receive a placebo or 20 mg of tadalafil taken as needed （maximum once daily）. Efficacy assessments included the International Index of Erectile Function, the Sexual Encounter Profile diary and Global Assessment Questions. Results： Tadalafil significantly improved erectile function as compared to the placebo （P 〈 0.001）. At the endpoint, the patients receiving 20 mg of tadalafil reported a greater mean per patient percentage of successful intercourse attempts （Sexual Encounter Profile question 3： 70.9% compared to 33.5% in the placebo） and a greater proportion of improved erections （Global Assessment Question： 86.2% compared to 30.1%）. Most （≥3%） treatment emergent adverse events were mild or moderate. The most common treatment emergent adverse events were headache, back pain, dizziness and dyspepsia. Conclusion： Tadalafil was an effective and well-tolerated treatment for ED in East and Southeast Asian men.展开更多
Low-intensity extracorporeal shockwave therapy(LiESWT)represents a promising treatment for patients with erectile dysfunction(ED).We investigated the efficacy of LiESWT combined with tadalafil 5 mg once daily in men w...Low-intensity extracorporeal shockwave therapy(LiESWT)represents a promising treatment for patients with erectile dysfunction(ED).We investigated the efficacy of LiESWT combined with tadalafil 5 mg once daily in men with type 2 diabetes mellitus(T2DM)and ED and compared LiESWT protocols administering different number of shockwaves.We performed a retrospective matched-pair comparison using data from a prospectively maintained database.Seventy-eight patients who received tadalafil 5 mg once dai7ly for 12 weeks+LiESWT performed with an electrohydraulic source for 3 weeks(Group A)were matched 1:1 to patients who received tadalafil 5 mg once daily alone for 12 weeks(Group B).A subgroup analysis was performed according to the number of shockwaves delivered during each session(1500,1800,and 2400 in subgroup A1,A2,and A3,respectively).The mean International Index of Erectile Function-5(IIEF-5)score variations with respect to baseline recorded at 4,12,and 24 weeks after the end of the treatment were investigated as treatment outcomes.The mean IIEF-5 scores significantly improved in all groups and subgroups at 4-week follow-up without intergroup differences.At 12-and 24-week follow-up,the mean IIEF-5 improvement was significantly higher among patients in the A3 subgroup(+5.0±2.1[P<0.001]and+4.7±2.3[P<0.001],respectively).The combined approach with tadalafil 5 mg once daily and LiESWT with a protocol involving 2400 shockwaves provides significant advantages in terms of IIEF-5 improvement and durability compared to tadalafil 5 mg once daily alone in patients with T2DM and ED.展开更多
We evaluated the efficacy and safety of as-needed tadalafil in a diverse clinical population （with varying patient demographics, disease severity, and comorbid medical conditions） of Asian men with erectile dysfunct...We evaluated the efficacy and safety of as-needed tadalafil in a diverse clinical population （with varying patient demographics, disease severity, and comorbid medical conditions） of Asian men with erectile dysfunction （ED）. An integrated analysis of five double-blind, placebo-controlled trials （N = 1 046） was performed. Patients were randomly assigned to receive 10 mg tadalafil （N = 185）, 20 mg tadalafil （N = 510）, or placebo （N = 351）. Efficacy assessments included the International Index of Erectile Function （IIEF）, Sexual Encounter Profile （SEP） diary and Global Assessment Question （GAQ）. Patients receiving 10 mg or 20 mg tadalafil showed significant improvement from baseline-to-end point on the Erectile Function domain of the International Index of Erectile Function （IIEF-EF） domain score in all clinical sub-populations analyzed, compared with patients receiving placebo （P 〈 0.001）. The 10-mg and 20-mg tadalafil groups showed a mean success rate of 64.1% and 70.5% for sexual intercourse attempts （SEP3, successful intercourse）, respectively, compared with 33.4% in the placebo group （P 〈 0.001）, and 85.5% and 85.4% reported improved erections at end point GAQ, respectively, versus 43.5% in the placebo group （P 〈 0.001）. Tadalafil was well tolerated across all groups studied. Headache and back pain were the most frequently reported adverse events. Overall, tadalafil was effective and well tolerated across a diverse clinical spectrum of Asian men with ED.展开更多
To evaluate patient preferences for sildenafil citrate or tadalafil （PDE-5 inhibitors available for the treatment of erectile dysfunction [ED]） and assess potential reasons for these preferences. Methods： This open...To evaluate patient preferences for sildenafil citrate or tadalafil （PDE-5 inhibitors available for the treatment of erectile dysfunction [ED]） and assess potential reasons for these preferences. Methods： This open-label study was conducted on Korean men taking sildenafil, at least 6 weeks prior to study entry, for ED. Following screening, patients continued sildenafil treatment for 4 weeks, then after a 1-week washout period, switched to tadalafil for 8 weeks. Patients then continued with their treatment of choice during an extension phase. Psychosocial factors （time concern, spontaneity, sexual self-confidence） were evaluated using Psychological and Interpersonal Relation- ship Scales （PAIRS）, while timing of dose to sexual attempt patterns were assessed from patient diaries. Results： The present study enrolled 160 Korean men （mean age 55 years） with prior median sildenafil use of 585 days. During the extension phase, 73.7% of patients elected to take tadalafil, whereas 26.3% chose sildenafil （P 〈 0.001）. After switching from sildenafil to tadalafil, mean PAIRS time concern scores decreased from 2.54 to 2.42 （P = 0.002）, with no statistically significant differences observed between the sildenafil and tadalafil assessment phases in sexual spontaneity and self-confidence scores. Sexual attempts made 〉 4 h to 〈 36 h post-dose occurred in 4.5% of patients during the sildenafil assessment phase compared with 17.5% during the tadalafil assessment phase. Conclusion： After experiencing both sildenafil and tadalafil, the majority of patients exhibited a preference for tadalafil. This preference might be influenced by psychosocial factors, such as decreased time concerns, and a broader window of opportunity available for sexual activity.展开更多
Once-daily tadalafil administration has been well established; however, studies about tadalafil once-daily treatment in the Chinese population are lacking. In this phase 4, postmarketing study, we ascertained the long...Once-daily tadalafil administration has been well established; however, studies about tadalafil once-daily treatment in the Chinese population are lacking. In this phase 4, postmarketing study, we ascertained the long-term safety and effectiveness of tadalafil 2.5 mg and 5.0 mg once daily in Chinese men with erectile dysfunction （n = 635）. The primary endpoint of the study was safety at 12 months as assessed by the proportion of patients experiencing at least one treatment-emergent adverse event （serious or nonserious）. The secondary endpoints included safety and effectiveness, measured by the International Index of Erectile Function-Erectile Function （IIEF-EF） domain scores. Similar adverse events to the known safety profile of tadalafil, such as nasopharyngitis, upper respiratory tract infection, headache, and dizziness, were detected. No new cardiovascular safety concerns were observed. After 3 months of treatment, significant increases in IIEF-EF domain scores were detected for both 2.5-mg （least squares [LS] mean change： 6.3; 95% confidence interval [CI]： 5.4-7.1; P 〈 0.001） and 5.0-mg （LS mean change： 7.4; 95% CI： 6.8-7.9; P 〈 0.001） tadalafil doses, and significance was maintained up to 12 months. In addition, approximately 40% of patients regained normal erectile function （IIEF-EF 〉26） following 1 year of tadalafil once-daily treatment. The findings in this study provide evidence for the extended effectiveness and tolerability of tadalafil, demonstrating no new safety concerns, in a Chinese population and make once-daily tadalafil administration a viable option for improving sexual performance and satisfaction in Chinese men with erectile dysfunction.展开更多
This study aimed to evaluate whether adding a vacuum erection device(VED)to regular use of Tadalafil could achieve better penile rehabilitation following posterior urethroplasty for pelvic fracture-related urethral in...This study aimed to evaluate whether adding a vacuum erection device(VED)to regular use of Tadalafil could achieve better penile rehabilitation following posterior urethroplasty for pelvic fracture-related urethral injury(PFUI).Altogether,78 PFUI patients with erectile dysfunction(ED)after primary posterior urethroplasty were enrolled and divided into two treatment groups:VED combined with Tadalafil(Group 1,n=36)and Tadalafil only(Group 2,n=42).Changes in penile length,testosterone level,International Index of Erectile Function-5(IIEF-5)questionnaire,Quality of Erection Questionnaire(QEQ),and nocturnal penile tumescence(NPT)testing were used to assess erectile function before and after 6 months of ED treatment.Results showed that the addition of VED to regular use of Tadalafil preserved more penile length statistically(0.4±0.9 vs-0.8±0.7 cm,P<0.01).IIEF-5 score and QEQ score in Group 1 were higher than Group 2(both P<0.05).After treatment,21/36(5&3%)Group 1 patients and 19/42(45.2%)Group 2 patients could complete vaginal penetration.Group 1 patients also had markedly improved testosterone levels(P=0.01).Unexpectedly,there was no significant difference in NPT testing between two therapies.For PFUI patients with ED after posterior urethroplasty,the addition of VED to regular use of Tadalafil could significantly improve their conditions-improving erection and increasing penile length-thus increasing patient satisfaction and confidence in penile rehabilitation.展开更多
Objectives:To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving clearance of fragments after shock wave lithotripsy(SWL)to treat renal calculi.Methods:Between January 2016 to December 20...Objectives:To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving clearance of fragments after shock wave lithotripsy(SWL)to treat renal calculi.Methods:Between January 2016 to December 2017,140 patients with solitary,non-branched,non-lower calyceal renal calculus and measuring less than 20 mm and treated with SWL were randomized to tamsulosin(group A)or tamsulosin plus tadalafil(group B).Therapy was given for a period of 4 weeks.Stone clearance rate,analgesic requirement,occurrence of steinstrasse,need for auxiliary procedures(endoscopic treatment),and adverse effects of drugs were recorded.Results:The overall clearance rate was 72.5%(50/69)in the group A and 90.1%(64/71)in the group B(pZ0.007).For stones up to 12 mm,the difference in the clearance rate was significant(pZ0.039)while it was not so for stones larger than 12 mm(pZ0.151).There was no statistically significant difference between the two groups with regards to analgesic requirement(pZ0.94),occurrence of steinstrasse(pZ0.101),need for auxiliary procedures(pZ0.76),and adverse effects of the drugs(pZ0.148).Conclusion:Our study shows that adjunctive medical expulsive therapy with tamsulosin and tadalafil achieves better clearance rate than tadalafil alone in patients receiving SWL for renal stones.展开更多
Aim： To examine the preference for two dosing regimens of 20 mg of tadalafil, on demand or three times per week, in men affected with erectile dysfunction （ED） in Italy. Methods： Scheduled Use versus on demand Reg...Aim： To examine the preference for two dosing regimens of 20 mg of tadalafil, on demand or three times per week, in men affected with erectile dysfunction （ED） in Italy. Methods： Scheduled Use versus on demand Regimen Evaluation （SURE） is a multicenter, crossover and open-label study, involving 94 urology centers in Italy. Patients aged 18 years or older affected with ED for at least 3 months were enrolled and randomized to 20 mg of tadalafil treatment on demand or three times per week for 5-6 weeks. After a 1-week washout, patients were crossed over to the alternate regimen for 5-6 weeks. A treatment preference question was used to determine the preferred treatment regimen. International Index of Erectile Function （IIEF） and Sexual Encounter Profile （SEP） questionnaire were used as efficacy measures. Results： A total of 1 058 men （mean age 54.8 years）, were randomized to treatment. Overall, 59.1% of patients preferred the on-demand regimen and 41.9% preferred the three times per week dosing. Both regimens were efficacious and well tolerated. Although a statistically higher improvement of the IIEF erectile function （IIEF-EF） domain score and the SEP questionnaire was reported for the three times per week compared to the ondemand treatment regimen, this difference was numerically minimal and lacking in clinical significance. Conclusion： Tadalafil is effective and well tolerated whether used on demand or three times per week. Patients should be given the option to choose the best treatment regimen according to personal needs and preferences.展开更多
Objective To evaluate the efficacy and safety of simultaneous administration of dutasteride,tadalafil and solifenacin in the treatment of benign prostatic hyperplasia(BPH)with overactive bladder symptoms and lower uri...Objective To evaluate the efficacy and safety of simultaneous administration of dutasteride,tadalafil and solifenacin in the treatment of benign prostatic hyperplasia(BPH)with overactive bladder symptoms and lower urinary tract obstruction in previously unsuccessfully treated men.Methods Patients in Group A(n=97)received dutasteride 0.5 mg/day,tadalafil 2.5 mg/day,and solifenacin 2.5 mg/day;Group B(n=95)received dutasteride 0.5 mg/day,tadalafil 5 mg/day,and solifenacin 5 mg/day;Group C(n=103)received dutasteride 0.5 mg/day,tadalafil 20 mg/day,and solifenacin 10 mg/day.The functional status of the lower urinary tract was assessed using the International Prostate Symptom Score(I-PSS),Overactive Bladder Questionnaire(OABq),International Index of Erectile Function(IIEF),and Male Sexual Health Questionnaire Ejaculatory Dysfunction(MSHQ-EjD)as well as uroflowmetry.Results The total score of the sexual function remained unchanged in Group B of patients 81.3 points vs.80.2 points(p>0.05)according to MSHQ-EjD,61.4 points vs.51.2 points(p>0.05)according to IIEF data.The total assessment of symptoms of hyperactivity significantly decreased in Group C according to OABq data after the 4th week of the study(17.5 points vs.26.1 points,p<0.05)and remained below the baseline until the end of the study(15.2 points).Conclusions The simultaneous administration of standard doses of dutasteride,solifenacin,and tadalafil for 3 months is safe,effective,and can be recommended for patients with BPH to reduce symptoms of obstruction and hyperactivity of the bladder and maintain sexual function.展开更多
Impairment of dopamine function, which is known to have major effects on behaviors and cognition, is one of the main problems associated with cerebral ischemia. Tadalafil, a long-acting phosphodiesterase type-5 inhibi...Impairment of dopamine function, which is known to have major effects on behaviors and cognition, is one of the main problems associated with cerebral ischemia. Tadalafil, a long-acting phosphodiesterase type-5 inhibitor, is known to ameliorate neurologic impairment induced by brain injury, but not in dopaminergic regions. We investigated the neuroprotective effects of treatment with tadalafil on cyclic guanosine monophosphate level and dopamine function following cerebral ischemia. Forty adult Mongolian gerbils were randomly and evenly divided into five groups （n = 8 in each group）： Sham-operation group, cerebral ischemia-induced and 0, 0.1, 1, and 10 mg/kg tadalafil-treated groups, respectively. Tadalafil dissolved in distilled water was administered orally for 7 consecutive days, starting 1 day after surgery. Cyclic guanosine monophosphate assay and immunohistochemistry were performed for thyrosine hydroxylase expression and western blot analysis for dopamine D2 receptor expression. A decrease in cyclic guanosine monophosphate level following cerebral ischemia was found with an increase in thyrosine hydroxylase activity and a decrease in dopamine D2 receptor expression in the striatum and substantia nigra region. However, treatment with tadalafil increased cyclic guanosine monophosphate expression, suppressed thyrosine hydroxylase expression and increased dopamine 92 receptor expression in the striatum and substantia nigra region in a dose-dependent manner. Tadalafil might ameliorate cerebral ischemia-induced dopaminergic neuron injury. Therefore, tadalafil has the potential as a new neuroprotective treatment strategy for cerebral ischemic injury.展开更多
Intravenous epoprostenol is recommended for World Health Organization functional class(WHO-FC) Ⅳ patients with pulmonary arterial hypertension(PAH) in the latest guidelines. However, in portopulmonary hypertension(Po...Intravenous epoprostenol is recommended for World Health Organization functional class(WHO-FC) Ⅳ patients with pulmonary arterial hypertension(PAH) in the latest guidelines. However, in portopulmonary hypertension(PoP H) patients, advanced liver dysfunction and/or thrombocytopenia often makes the use of intravenous epoprostenol challenging. Here we report the cases of two WHO-FC Ⅳ PoP H patients who were successfully treated with a combination of two oral vasodilators used to treat PAH: ambrisentan and tadalafil. Oral vasodilator therapy using a combination of ambrisentan and tadalafil may be a safe and effective therapeutic option for WHO-FC Ⅳ PoP H patients and should be considered for selected patients with severe and rapidly progressing PoP H.展开更多
A recent report introduced the phosphodiesterase-5 inhibition by vardenafil as a novel treatment of portal hypertension in patients with cirrhosis.In the herein presented"letter to the editor",the administra...A recent report introduced the phosphodiesterase-5 inhibition by vardenafil as a novel treatment of portal hypertension in patients with cirrhosis.In the herein presented"letter to the editor",the administration of tadalafil did not influence portal haemodynamics but impaired systemic haemodynamics in patients with cirrhosis.Our observations concur with the results of a report in a previous issue of World Journal of Gastroenterology(October 2008).Moreover,tadalafil adversely affected renal function in patients with decompensated liver disease.展开更多
The number of the circulating angiogenic cells （CACs） and colony forming units （CFUs） derived from cultured circulating mononuclear cells （MNCs） represents a laboratory surrogate for endothelial cell repair abil...The number of the circulating angiogenic cells （CACs） and colony forming units （CFUs） derived from cultured circulating mononuclear cells （MNCs） represents a laboratory surrogate for endothelial cell repair ability. The serum of men with erectile dysfunction （ED） and vascular risk factors （VRFs） showed an increased level of endothelial cell damage/dysfunction markers and reduced the numbers of CACs and CFUs derived from the cells of healthy men. We analyzed whether treating men with ED and VRFs with the selective phosphodiesterase type 5 inhibitor tadalafil improved the endothelial cell repair ability and reduced the levels of the serum markers of endothelial cell damage/dysfunction. MNCs from healthy men were cultured with 20% serum from 36 ED patients to obtain CACs and CFUs. The ED patients were evaluated before and after 4weeks of treatment with tadalafil （20 mg every other day） or with a placebo. The tadalafil treatment improved erectile function （P = 0.0028）, but had no effect on the inhibitory effects of serum from ED patients on the CACs and CFUs derived from healthy men. The levels of endothelin-1 （P = 0.011） and tissue type plasminogen activator （P = 0.005） were reduced after treatment compared to baseline and those of the placebo group, whereas no changes were observed in the E-selectin levels. The tadalafil treatment in the ED patients with VRFs resulted in only a modest effect on the laboratory measures of the endothelial cell damage/dysfunction and repair ability. The proposed beneficial effect of phosphodiesterase type 5 inhibition on vascular homeostasis requires further analysis.展开更多
It is of great importance to investigate an effective and reliable medication against chronic renal failure (CRF)-related erectile dysfunction (ED),which aims to improve patients' life qualities.The concentrations...It is of great importance to investigate an effective and reliable medication against chronic renal failure (CRF)-related erectile dysfunction (ED),which aims to improve patients' life qualities.The concentrations of cyclic guanosine monophosphate (cGMP) in the corpus cavernosal smooth muscle of both CRF and control rabbits were measured.The effects of various concentrations of tadalafil,papaverine,and sodium nitroprusside on the relaxation responses of corpus cavernosal smooth muscle pre-contracted with phenylephrine in CRF rabbits were observed.There was significant difference in the concentration of cGMP between CRF and control rabbits (P<0.01).Tadalafil had the greatest impacts on CRF rabbits when given the same concentration of papaverine or sodium nitroprusside and particularly significant differences were identified under the concentration levels of 10-5 and 10-4 mol/L (P<0.01).The results suggest that the cGMP concentrations of the corpus cavernosum had been greatly reduced in CRF rabbits compared with control rabbits and that tadalafil may be an ideal medication for use in the treatment of CRF-related ED.展开更多
文摘Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.
基金sponsored by A.Menarini China Holding Co.,Ltd.(Shanghai,China).A.Menarini China had no influence on the data and no competinginterests.
文摘The long-term safety and effectiveness of once-daily tadalafil is crucial,but limited data are available in Chinese patients witherectile dysfunction(ED).In this post-marketing,multicenter,randomized,open-label trial with 2-year follow-up,635 ED caseswere randomized to receive daily oral tadalafil 2.5 mg or 5 mg for 3 months,of whom 580 continued once-daily tadalafil 5 mg for21 months.Treatment-emergent adverse events in the 12-month and 24-month period were similar,with the most common beingviral upper respiratory tract infection,upper respiratory tract infection,and headache.Significant improvement from baseline inthe International Index of Erectile Function-Erectile Function(IIEF-EF)score was detected at month 12(least squares mean[LSM]change:7.9,95%confidence interval[CI]:7.5–8.4,P<0.001)and was maintained to month 24(LSM change:8.6,95%CI:8.1–9.0,P<0.001).The proportions of patients regaining normal erectile function(IIEF-EF score≥26)were 43.7%and 48.0%at months 12 and 24,respectively.Global Assessment Questionnaire results showed improved erection function in 97.5%ofpatients and improved ability to engage in sexual activity in 95.9%of patients at month 12;these values were 96.1%and 95.0%at month 24,respectively.The quality of sexual life score based on the Sexual Life Quality Questionnaire(SLQQ)was increased by52.2%at month 12 and by 55.3%at month 24(both P<0.001).The treatment satisfaction score determined by SLQQ(mean±standard deviation)was 62.4±21.0 at month 12 versus 65.9±20.2 at month 24.Two-year daily application of tadalafil 5mg in Chinese men with ED showed a favorable safety profile and durable improvement in sexual performance and satisfaction.
文摘Objective: According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.Methods: In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.Results: Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05).Conclusion: Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.
文摘A highly sensitive liquid chromatography-tandem mass spectrometry（LC-MS/MS） method was developed for the determination of tadalafil（TAD） in human plasma. TAD and its deuterated internal standard（IS）, tadalafil-d3, were extracted from 200 mL plasma using Phenomenex Strata-X-C 33 m extraction cartridges. Chromatographic analysis was carried out on Synergi Hydro-RP C18（100 mm × 4.6 mm, 4 mm）column with a mobile phase consisting of methanol and 10 m M ammonium formate, p H 4.0（90：10, v/v）,delivered at a flow rate of 0.9 m L/min. Quantitation of the protonated analyte was done on a triple quadrupole mass spectrometer using multiple reaction monitoring via electrospray ionization. The precursor to product ions transitions monitored for TAD and TAD-d3 were m/z 390.3-268.2 and m/z393.1-271.2, respectively. The calibration curve was linear over the concentration range of 0.50–500 ng/m L with correlation coefficient, r2 Z 0.9994. Acceptable intra-batch and inter-batch precision（r3.7%） and accuracy（97.8% to 104.1%） were obtained at five concentration levels. The recovery of TAD from spiked plasma was highly precise and quantitative（98.95% to 100.61%）. Further, the effect of endogenous matrix components was minimal. TAD was found to be stable under different storage conditions in human plasma and also in whole blood samples. The validated method was successfully used to determine TAD plasma concentration in a bioequivalence study with 20 mg TAD tablets in 24 healthy volunteers. Method performance was evaluated by reanalyzing 115 study samples.
文摘Aim： To assess the efficacy and safety of tadalafil in comparison to a placebo, when taken on demand for 12 weeks by East/Southeast Asian men with erectile dysfunction （ED）, Methods： This multicenter, randomized, double-blind, parallel group, placebo-controlled study was conducted at 17 centers across East and Southeast Asia between August 2002 and February 2003. Men more than 18 years of age with mild to severe ED of various etiologies were randomized to receive a placebo or 20 mg of tadalafil taken as needed （maximum once daily）. Efficacy assessments included the International Index of Erectile Function, the Sexual Encounter Profile diary and Global Assessment Questions. Results： Tadalafil significantly improved erectile function as compared to the placebo （P 〈 0.001）. At the endpoint, the patients receiving 20 mg of tadalafil reported a greater mean per patient percentage of successful intercourse attempts （Sexual Encounter Profile question 3： 70.9% compared to 33.5% in the placebo） and a greater proportion of improved erections （Global Assessment Question： 86.2% compared to 30.1%）. Most （≥3%） treatment emergent adverse events were mild or moderate. The most common treatment emergent adverse events were headache, back pain, dizziness and dyspepsia. Conclusion： Tadalafil was an effective and well-tolerated treatment for ED in East and Southeast Asian men.
文摘Low-intensity extracorporeal shockwave therapy(LiESWT)represents a promising treatment for patients with erectile dysfunction(ED).We investigated the efficacy of LiESWT combined with tadalafil 5 mg once daily in men with type 2 diabetes mellitus(T2DM)and ED and compared LiESWT protocols administering different number of shockwaves.We performed a retrospective matched-pair comparison using data from a prospectively maintained database.Seventy-eight patients who received tadalafil 5 mg once dai7ly for 12 weeks+LiESWT performed with an electrohydraulic source for 3 weeks(Group A)were matched 1:1 to patients who received tadalafil 5 mg once daily alone for 12 weeks(Group B).A subgroup analysis was performed according to the number of shockwaves delivered during each session(1500,1800,and 2400 in subgroup A1,A2,and A3,respectively).The mean International Index of Erectile Function-5(IIEF-5)score variations with respect to baseline recorded at 4,12,and 24 weeks after the end of the treatment were investigated as treatment outcomes.The mean IIEF-5 scores significantly improved in all groups and subgroups at 4-week follow-up without intergroup differences.At 12-and 24-week follow-up,the mean IIEF-5 improvement was significantly higher among patients in the A3 subgroup(+5.0±2.1[P<0.001]and+4.7±2.3[P<0.001],respectively).The combined approach with tadalafil 5 mg once daily and LiESWT with a protocol involving 2400 shockwaves provides significant advantages in terms of IIEF-5 improvement and durability compared to tadalafil 5 mg once daily alone in patients with T2DM and ED.
文摘We evaluated the efficacy and safety of as-needed tadalafil in a diverse clinical population （with varying patient demographics, disease severity, and comorbid medical conditions） of Asian men with erectile dysfunction （ED）. An integrated analysis of five double-blind, placebo-controlled trials （N = 1 046） was performed. Patients were randomly assigned to receive 10 mg tadalafil （N = 185）, 20 mg tadalafil （N = 510）, or placebo （N = 351）. Efficacy assessments included the International Index of Erectile Function （IIEF）, Sexual Encounter Profile （SEP） diary and Global Assessment Question （GAQ）. Patients receiving 10 mg or 20 mg tadalafil showed significant improvement from baseline-to-end point on the Erectile Function domain of the International Index of Erectile Function （IIEF-EF） domain score in all clinical sub-populations analyzed, compared with patients receiving placebo （P 〈 0.001）. The 10-mg and 20-mg tadalafil groups showed a mean success rate of 64.1% and 70.5% for sexual intercourse attempts （SEP3, successful intercourse）, respectively, compared with 33.4% in the placebo group （P 〈 0.001）, and 85.5% and 85.4% reported improved erections at end point GAQ, respectively, versus 43.5% in the placebo group （P 〈 0.001）. Tadalafil was well tolerated across all groups studied. Headache and back pain were the most frequently reported adverse events. Overall, tadalafil was effective and well tolerated across a diverse clinical spectrum of Asian men with ED.
文摘To evaluate patient preferences for sildenafil citrate or tadalafil （PDE-5 inhibitors available for the treatment of erectile dysfunction [ED]） and assess potential reasons for these preferences. Methods： This open-label study was conducted on Korean men taking sildenafil, at least 6 weeks prior to study entry, for ED. Following screening, patients continued sildenafil treatment for 4 weeks, then after a 1-week washout period, switched to tadalafil for 8 weeks. Patients then continued with their treatment of choice during an extension phase. Psychosocial factors （time concern, spontaneity, sexual self-confidence） were evaluated using Psychological and Interpersonal Relation- ship Scales （PAIRS）, while timing of dose to sexual attempt patterns were assessed from patient diaries. Results： The present study enrolled 160 Korean men （mean age 55 years） with prior median sildenafil use of 585 days. During the extension phase, 73.7% of patients elected to take tadalafil, whereas 26.3% chose sildenafil （P 〈 0.001）. After switching from sildenafil to tadalafil, mean PAIRS time concern scores decreased from 2.54 to 2.42 （P = 0.002）, with no statistically significant differences observed between the sildenafil and tadalafil assessment phases in sexual spontaneity and self-confidence scores. Sexual attempts made 〉 4 h to 〈 36 h post-dose occurred in 4.5% of patients during the sildenafil assessment phase compared with 17.5% during the tadalafil assessment phase. Conclusion： After experiencing both sildenafil and tadalafil, the majority of patients exhibited a preference for tadalafil. This preference might be influenced by psychosocial factors, such as decreased time concerns, and a broader window of opportunity available for sexual activity.
文摘Once-daily tadalafil administration has been well established; however, studies about tadalafil once-daily treatment in the Chinese population are lacking. In this phase 4, postmarketing study, we ascertained the long-term safety and effectiveness of tadalafil 2.5 mg and 5.0 mg once daily in Chinese men with erectile dysfunction （n = 635）. The primary endpoint of the study was safety at 12 months as assessed by the proportion of patients experiencing at least one treatment-emergent adverse event （serious or nonserious）. The secondary endpoints included safety and effectiveness, measured by the International Index of Erectile Function-Erectile Function （IIEF-EF） domain scores. Similar adverse events to the known safety profile of tadalafil, such as nasopharyngitis, upper respiratory tract infection, headache, and dizziness, were detected. No new cardiovascular safety concerns were observed. After 3 months of treatment, significant increases in IIEF-EF domain scores were detected for both 2.5-mg （least squares [LS] mean change： 6.3; 95% confidence interval [CI]： 5.4-7.1; P 〈 0.001） and 5.0-mg （LS mean change： 7.4; 95% CI： 6.8-7.9; P 〈 0.001） tadalafil doses, and significance was maintained up to 12 months. In addition, approximately 40% of patients regained normal erectile function （IIEF-EF 〉26） following 1 year of tadalafil once-daily treatment. The findings in this study provide evidence for the extended effectiveness and tolerability of tadalafil, demonstrating no new safety concerns, in a Chinese population and make once-daily tadalafil administration a viable option for improving sexual performance and satisfaction in Chinese men with erectile dysfunction.
基金This study was supported,in part,by the National Natural Science Foundation of China(No.81671451)the Shanghai Key Laboratory of Forensic Medicine(Academy of Forensic Science,No.KF1915).
文摘This study aimed to evaluate whether adding a vacuum erection device(VED)to regular use of Tadalafil could achieve better penile rehabilitation following posterior urethroplasty for pelvic fracture-related urethral injury(PFUI).Altogether,78 PFUI patients with erectile dysfunction(ED)after primary posterior urethroplasty were enrolled and divided into two treatment groups:VED combined with Tadalafil(Group 1,n=36)and Tadalafil only(Group 2,n=42).Changes in penile length,testosterone level,International Index of Erectile Function-5(IIEF-5)questionnaire,Quality of Erection Questionnaire(QEQ),and nocturnal penile tumescence(NPT)testing were used to assess erectile function before and after 6 months of ED treatment.Results showed that the addition of VED to regular use of Tadalafil preserved more penile length statistically(0.4±0.9 vs-0.8±0.7 cm,P<0.01).IIEF-5 score and QEQ score in Group 1 were higher than Group 2(both P<0.05).After treatment,21/36(5&3%)Group 1 patients and 19/42(45.2%)Group 2 patients could complete vaginal penetration.Group 1 patients also had markedly improved testosterone levels(P=0.01).Unexpectedly,there was no significant difference in NPT testing between two therapies.For PFUI patients with ED after posterior urethroplasty,the addition of VED to regular use of Tadalafil could significantly improve their conditions-improving erection and increasing penile length-thus increasing patient satisfaction and confidence in penile rehabilitation.
文摘Objectives:To compare the efficacy of tamsulosin versus tamsulosin plus tadalafil in achieving clearance of fragments after shock wave lithotripsy(SWL)to treat renal calculi.Methods:Between January 2016 to December 2017,140 patients with solitary,non-branched,non-lower calyceal renal calculus and measuring less than 20 mm and treated with SWL were randomized to tamsulosin(group A)or tamsulosin plus tadalafil(group B).Therapy was given for a period of 4 weeks.Stone clearance rate,analgesic requirement,occurrence of steinstrasse,need for auxiliary procedures(endoscopic treatment),and adverse effects of drugs were recorded.Results:The overall clearance rate was 72.5%(50/69)in the group A and 90.1%(64/71)in the group B(pZ0.007).For stones up to 12 mm,the difference in the clearance rate was significant(pZ0.039)while it was not so for stones larger than 12 mm(pZ0.151).There was no statistically significant difference between the two groups with regards to analgesic requirement(pZ0.94),occurrence of steinstrasse(pZ0.101),need for auxiliary procedures(pZ0.76),and adverse effects of the drugs(pZ0.148).Conclusion:Our study shows that adjunctive medical expulsive therapy with tamsulosin and tadalafil achieves better clearance rate than tadalafil alone in patients receiving SWL for renal stones.
文摘Aim： To examine the preference for two dosing regimens of 20 mg of tadalafil, on demand or three times per week, in men affected with erectile dysfunction （ED） in Italy. Methods： Scheduled Use versus on demand Regimen Evaluation （SURE） is a multicenter, crossover and open-label study, involving 94 urology centers in Italy. Patients aged 18 years or older affected with ED for at least 3 months were enrolled and randomized to 20 mg of tadalafil treatment on demand or three times per week for 5-6 weeks. After a 1-week washout, patients were crossed over to the alternate regimen for 5-6 weeks. A treatment preference question was used to determine the preferred treatment regimen. International Index of Erectile Function （IIEF） and Sexual Encounter Profile （SEP） questionnaire were used as efficacy measures. Results： A total of 1 058 men （mean age 54.8 years）, were randomized to treatment. Overall, 59.1% of patients preferred the on-demand regimen and 41.9% preferred the three times per week dosing. Both regimens were efficacious and well tolerated. Although a statistically higher improvement of the IIEF erectile function （IIEF-EF） domain score and the SEP questionnaire was reported for the three times per week compared to the ondemand treatment regimen, this difference was numerically minimal and lacking in clinical significance. Conclusion： Tadalafil is effective and well tolerated whether used on demand or three times per week. Patients should be given the option to choose the best treatment regimen according to personal needs and preferences.
文摘Objective To evaluate the efficacy and safety of simultaneous administration of dutasteride,tadalafil and solifenacin in the treatment of benign prostatic hyperplasia(BPH)with overactive bladder symptoms and lower urinary tract obstruction in previously unsuccessfully treated men.Methods Patients in Group A(n=97)received dutasteride 0.5 mg/day,tadalafil 2.5 mg/day,and solifenacin 2.5 mg/day;Group B(n=95)received dutasteride 0.5 mg/day,tadalafil 5 mg/day,and solifenacin 5 mg/day;Group C(n=103)received dutasteride 0.5 mg/day,tadalafil 20 mg/day,and solifenacin 10 mg/day.The functional status of the lower urinary tract was assessed using the International Prostate Symptom Score(I-PSS),Overactive Bladder Questionnaire(OABq),International Index of Erectile Function(IIEF),and Male Sexual Health Questionnaire Ejaculatory Dysfunction(MSHQ-EjD)as well as uroflowmetry.Results The total score of the sexual function remained unchanged in Group B of patients 81.3 points vs.80.2 points(p>0.05)according to MSHQ-EjD,61.4 points vs.51.2 points(p>0.05)according to IIEF data.The total assessment of symptoms of hyperactivity significantly decreased in Group C according to OABq data after the 4th week of the study(17.5 points vs.26.1 points,p<0.05)and remained below the baseline until the end of the study(15.2 points).Conclusions The simultaneous administration of standard doses of dutasteride,solifenacin,and tadalafil for 3 months is safe,effective,and can be recommended for patients with BPH to reduce symptoms of obstruction and hyperactivity of the bladder and maintain sexual function.
基金supported by the Research Fund of Gachon University Gil Medical Center in 2011the National Research Foundation of Korea funded by the Korean Government,No. 2012R1A1A1013173
文摘Impairment of dopamine function, which is known to have major effects on behaviors and cognition, is one of the main problems associated with cerebral ischemia. Tadalafil, a long-acting phosphodiesterase type-5 inhibitor, is known to ameliorate neurologic impairment induced by brain injury, but not in dopaminergic regions. We investigated the neuroprotective effects of treatment with tadalafil on cyclic guanosine monophosphate level and dopamine function following cerebral ischemia. Forty adult Mongolian gerbils were randomly and evenly divided into five groups （n = 8 in each group）： Sham-operation group, cerebral ischemia-induced and 0, 0.1, 1, and 10 mg/kg tadalafil-treated groups, respectively. Tadalafil dissolved in distilled water was administered orally for 7 consecutive days, starting 1 day after surgery. Cyclic guanosine monophosphate assay and immunohistochemistry were performed for thyrosine hydroxylase expression and western blot analysis for dopamine D2 receptor expression. A decrease in cyclic guanosine monophosphate level following cerebral ischemia was found with an increase in thyrosine hydroxylase activity and a decrease in dopamine D2 receptor expression in the striatum and substantia nigra region. However, treatment with tadalafil increased cyclic guanosine monophosphate expression, suppressed thyrosine hydroxylase expression and increased dopamine 92 receptor expression in the striatum and substantia nigra region in a dose-dependent manner. Tadalafil might ameliorate cerebral ischemia-induced dopaminergic neuron injury. Therefore, tadalafil has the potential as a new neuroprotective treatment strategy for cerebral ischemic injury.
文摘Intravenous epoprostenol is recommended for World Health Organization functional class(WHO-FC) Ⅳ patients with pulmonary arterial hypertension(PAH) in the latest guidelines. However, in portopulmonary hypertension(PoP H) patients, advanced liver dysfunction and/or thrombocytopenia often makes the use of intravenous epoprostenol challenging. Here we report the cases of two WHO-FC Ⅳ PoP H patients who were successfully treated with a combination of two oral vasodilators used to treat PAH: ambrisentan and tadalafil. Oral vasodilator therapy using a combination of ambrisentan and tadalafil may be a safe and effective therapeutic option for WHO-FC Ⅳ PoP H patients and should be considered for selected patients with severe and rapidly progressing PoP H.
文摘A recent report introduced the phosphodiesterase-5 inhibition by vardenafil as a novel treatment of portal hypertension in patients with cirrhosis.In the herein presented"letter to the editor",the administration of tadalafil did not influence portal haemodynamics but impaired systemic haemodynamics in patients with cirrhosis.Our observations concur with the results of a report in a previous issue of World Journal of Gastroenterology(October 2008).Moreover,tadalafil adversely affected renal function in patients with decompensated liver disease.
文摘The number of the circulating angiogenic cells （CACs） and colony forming units （CFUs） derived from cultured circulating mononuclear cells （MNCs） represents a laboratory surrogate for endothelial cell repair ability. The serum of men with erectile dysfunction （ED） and vascular risk factors （VRFs） showed an increased level of endothelial cell damage/dysfunction markers and reduced the numbers of CACs and CFUs derived from the cells of healthy men. We analyzed whether treating men with ED and VRFs with the selective phosphodiesterase type 5 inhibitor tadalafil improved the endothelial cell repair ability and reduced the levels of the serum markers of endothelial cell damage/dysfunction. MNCs from healthy men were cultured with 20% serum from 36 ED patients to obtain CACs and CFUs. The ED patients were evaluated before and after 4weeks of treatment with tadalafil （20 mg every other day） or with a placebo. The tadalafil treatment improved erectile function （P = 0.0028）, but had no effect on the inhibitory effects of serum from ED patients on the CACs and CFUs derived from healthy men. The levels of endothelin-1 （P = 0.011） and tissue type plasminogen activator （P = 0.005） were reduced after treatment compared to baseline and those of the placebo group, whereas no changes were observed in the E-selectin levels. The tadalafil treatment in the ED patients with VRFs resulted in only a modest effect on the laboratory measures of the endothelial cell damage/dysfunction and repair ability. The proposed beneficial effect of phosphodiesterase type 5 inhibition on vascular homeostasis requires further analysis.
文摘It is of great importance to investigate an effective and reliable medication against chronic renal failure (CRF)-related erectile dysfunction (ED),which aims to improve patients' life qualities.The concentrations of cyclic guanosine monophosphate (cGMP) in the corpus cavernosal smooth muscle of both CRF and control rabbits were measured.The effects of various concentrations of tadalafil,papaverine,and sodium nitroprusside on the relaxation responses of corpus cavernosal smooth muscle pre-contracted with phenylephrine in CRF rabbits were observed.There was significant difference in the concentration of cGMP between CRF and control rabbits (P<0.01).Tadalafil had the greatest impacts on CRF rabbits when given the same concentration of papaverine or sodium nitroprusside and particularly significant differences were identified under the concentration levels of 10-5 and 10-4 mol/L (P<0.01).The results suggest that the cGMP concentrations of the corpus cavernosum had been greatly reduced in CRF rabbits compared with control rabbits and that tadalafil may be an ideal medication for use in the treatment of CRF-related ED.
