Tadalafil Might Ease Symptoms of Benign Prostatic Hyperplasia

Allan S. Brett, MD

This drug, widely used for erectile dysfunction, improved urinary flow rates modestly in patients with BPH.

Phosphodiesterase-5 inhibitors are known mainly for treating erectile dysfunction, but one of them — tadalafil (Cialis) — also is FDA-approved for treating patients with symptomatic benign prostatic hyperplasia (BPH); the mechanism of action for mitigating BPH is unclear.

In this analysis of pooled data from four previously published randomized trials, industry-supported researchers present outcomes in about 1200 men with moderate-to-severe BPH who received daily tadalafil (5 mg) or placebo for 12 weeks. The 35-point International Prostate Symptom Score (I-PSS) improved by an average of about 2 points more with tadalafil than with placebo, which is a significant difference. Additionally, from a mean baseline maximum urinary flow rate of about 11 mL/second, maximum flow rates increased by 1.8 mL/second with tadalafil and 1.2 mL/second with placebo — also a significant difference.

Citation(s):

Roehrborn CG et al. Effects of tadalafil once daily on maximum urinary flow rate in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. J Urol 2014 Apr; 191:1045.