title: The role of PDE5 inhibitors in penile septal scar remodeling: assessment of clinical and radiological outcomes.
abstract: BACKGROUND
  Effective oral medication for use in men with Peyronie's disease (PD) has been an area of interest of the medical community and lay public for decades. Isolated septal scars (ISS) without evidence of penile deformity is a relatively new clinical entity, and at present, there is paucity in the published literature regarding its treatment. Current research into the use of phosphodiesterase type 5 (PDE5) inhibitors in regulating penile erectile response has revealed an alternative role for PDE5 inhibitors in decreasing oxidative stress-associated inflammatory change as seen in PD.
  
  
  OBJECTIVE
  To examine the presence of ISS and assess the efficacy of PDE5 inhibitor use in septal scar remodeling.
  
  
  METHODS
  Retrospective review of prospective database on all men who underwent penile Doppler ultrasound between December 2007 and December 2009.
  
  
  METHODS
  Of the 65 men with ultrasonographic-confirmed ISS, 35 men received tadalafil 2.5 mg daily over a 6-month period. The clinical outcomes between the two groups were compared using International Index of Erectile Function (IIEF)-5 score and 6 months penile Doppler ultrasound follow up.
  
  
  RESULTS
  The mean age for the tadalafil group was 43.2 (20-65) years, similar to the control group at 44.2 (34-72) years. The length of time from onset to presentation was 22 (6 to 40) months. The majority of ultrasonographic-proven ISS was not clinically palpable and complaint of decreased penile rigidity (66%) was the predominant feature. Treatment with low-dose daily tadalafil did not result in any significant side effects (such as headache and flushing) or discontinuation. The tadalafil group reported higher IIEF-5 score (pretreatment 11/25 to post-treatment 18/25) (P < 0.01) and resolution of septal scar were recorded in 24 patients (69%) compared to three patients (10%) in the control group.
  
  
  CONCLUSIONS
  Low-dose daily tadalafil is a safe and effective treatment option in septal scar remodeling.
authors.affiliation: St Joseph Health Care, London, Ontario, Canada. ericchg@hotmail.com
authors.forename: Eric
authors.initials: E
authors.lastname: Chung
authors.forename: Ling
authors.initials: L
authors.lastname: Deyoung
authors.forename: Gerald B
authors.initials: GB
authors.lastname: Brock
mesh_terms: D000368:Aged; D002243:Carbolines / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects; D010411:Penile Induration / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010413:Penis / Q000000981:diagnostic imaging / Q000187:drug effects; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011859:Radiography; D012189:Retrospective Studies; D000068581:Tadalafil; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D002243:Carbolines; D058986:Phosphodiesterase 5 Inhibitors; D000068581:Tadalafil