The effect of tadalafil 5 mg on erection and persistent storage lower urinary tract symptoms after transurethral resection of prostate: a randomized controlled study.

Background: We conducted a double-blind, randomized controlled trial to evaluate the effect of early administration of tadalafil (5 mg once daily) on persistent storage lower urinary tract symptoms (LUTS) and erectile function following transurethral resection of the prostate (TURP). All enrolled patients underwent TURP and were randomly assigned to one of two groups: Group A received tadalafil (5 mg once daily) postoperatively, while Group B received a placebo. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) questionnaire, and LUTS were evaluated using the International Prostate Symptom Score (IPSS). The study was conducted at a tertiary care hospital between May 2021 and October 2022.

Results: A total of 195 patients were enrolled and randomized into two groups: Group A (n = 103), which received tadalafil 5 mg once daily, and Group B (n = 92), which received a placebo. The mean ± standard deviation (SD) scores for the International Index of Erectile Function (IIEF-5) in Group A at 1, 3, and 6 months post-TURP were 11.59 ± 1.90, 19.80 ± 1.12, and 20.97 ± 0.72, respectively. In Group B, the corresponding scores were 4.88 ± 0.82, 12.86 ± 1.56, and 15.32 ± 1.28. These differences were statistically significant (P < 0.001). Similarly, the mean ± SD values for the International Prostate Symptom Score (IPSS) in Group A at 1, 3, and 6 months post-TURP were 7.31 ± 1.66, 4.46 ± 0.97, and 2.33 ± 0.69, respectively, compared to 9.62 ± 3.34, 5.40 ± 1.98, and 2.83 ± 1.27 in Group B (P < 0.001). Regarding storage symptom subscores, Group A demonstrated preoperative and postoperative mean ± SD values of 8.63 ± 1.82, 3.05 ± 0.78, 1.63 ± 0.49, and 0.92 ± 0.67 at preoperative, 1, 3, and 6 months, respectively. In contrast, Group B showed corresponding values of 3.22 ± 0.72, 2.48 ± 0.50, and 1.69 ± 0.47. These differences were also statistically significant (P < 0.001).

Conclusion: Tadalafil 5 mg daily as monotherapy following TURP can lead to early improvement in erectile function; however, its effect on persistent storage lower urinary tract symptoms (LUTS) post-TURP appears to be modest.

Trial registration: Our study has been approved by local ethical committee Kafrelsheikh university(MKSU50-3-1) on 20/5/2021 and by clinical trials (NCT06788704) on 25/1/2025.