title: Effects of daily tadalafil on lower urinary tract symptoms in young men with multiple sclerosis and erectile dysfunction: a pilot study.
abstract: OBJECTIVE
  Men affected by multiple sclerosis often experience neurogenic overactive bladder (OAB), lower urinary tract symptoms and erectile dysfunction (ED). The aim of the study was to investigate modifications of urinary and sexual functions after administration of daily tadalafil (TAD) 5 mg.
  
  
  METHODS
  Twenty men were enrolled in a single-blind, 4-week prospective study while 10 men without treatment served as controls. Primary outcomes were changes from baseline of International Prostate Symptom (IPSS), OAB questionnaire (OAB-q-short form) and International Index of Erectile Function (IIEF-5) scores. To evaluate the influence of bladder filling on somatic reflexes, we studied variations of the H-reflex evoked by electrical stimuli applied to the tibial nerve at the popliteal fossa and recorded from the soleus muscle. Also testosterone/estradiol (T/E) ratio was measured before and after treatment.
  
  
  RESULTS
  In TAD group, an improvement in IPSS (p < 0.001), OAB-q (p < 0.001) and IIEF-5 (p < 0.001) scores was found. Also, an increase in Qmax(p < 0.01) and T/E ratio (p < 0.01) was found with a concomitant reduction in post-void residual volume (p < 0.001) without any changes in the H-reflex.
  
  
  CONCLUSIONS
  The study demonstrates for the first time that daily TAD in patients with multiple sclerosis improves storage symptoms, post-void residual volume, steroid hormone pattern and ED without urodynamic changes.
authors.affiliation: Department of Experimental Medicine, Endocrinology and Food and Science Section, Sapienza University of Rome, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Francomano
authors.affiliation: Department of Experimental Medicine, Endocrinology and Food and Science Section, Sapienza University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ilacqua
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cortese
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tartaglia
authors.affiliation: Department of Experimental Medicine, Endocrinology and Food and Science Section, Sapienza University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lenzi
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Inghilleri
authors.affiliation: Department of Experimental Medicine, Endocrinology and Food and Science Section, Sapienza University of Rome, Rome, Italy. aversa@unicz.it.|Department of Experimental and Clinical Medicine, University Magna Graecia Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy. aversa@unicz.it.
authors.forename: A
authors.initials: A
authors.lastname: Aversa
mesh_terms: D000328:Adult; D007172:Erectile Dysfunction / Q000150:complications*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D016037:Single-Blind Method; D000068581:Tadalafil / Q000627:therapeutic use*
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D000068581:Tadalafil
keywords: Estradiol; H-reflex; LUTS; Neurogenic bladder; Testosterone