ABSTRACT
Objective
The objective of this research is to thoroughly investigate the effect of a daily intake of 5mg tadalafil on ejaculation times, erectile functionality, and lower urinary tract symptoms (LUTS) in males diagnosed with erectile dysfunction.
Materials and Methods
In this retrospective study, 60 male patients suffering from erectile dysfunction were evaluated using the International Index of Erectile Function Questionnaire-5 (IIEF-5), Intravaginal Ejaculatory Latency Time (IELT), and International Prostate Symptom Scores (IPSS). The patients were administered a daily dosage of 5mg tadalafil over a period of three months. Subsequent assessments for erection quality, ejaculatory timing, and LUTS were performed. Additionally, fasting blood glucose levels, total testosterone, and lipid profiles were measured. Statistical comparisons were done using the independent-samples t-test to analyze pre- and post-treatment scores.
Results
The average age of participants was noted as 50.4±7.9 years, with the mean baseline serum testosterone at 444.6±178.6 ng/dL, total cholesterol at 188.7±29.6 mg/dL, and fasting blood sugar at 104 (80-360) mg/dL. Initial IELT recorded a mean of 2.2±1.4 minutes, IIEF-5 at 9.5±3.7, and IPSS at 14.1±4.5. Following the three-month treatment, mean IELT improved to 3.4±1.9 minutes, IIEF-5 scores soared to 16.1±4.7, and IPSS dropped to 10.4±3.8. A statistically significant enhancement was observed in IELT and IIEF-5, coupled with a significant decline in IPSS (p<0.01).
Conclusion
The consistent administration of 5mg tadalafil daily appears to be an effective and safe approach for managing erectile dysfunction and related LUTS, contributing to an increased ejaculatory latency time.
Keywords: Tadalafil, Ejaculation, Erectile Dysfunction, Therapeutics
INTRODUCTION
Premature ejaculation (PE), which is a common male sexual dysfunction, affects approximately 9-30% of men globally. It manifests as ejaculation occurring with minimal sexual stimulation, often before or shortly after vaginal penetration, resulting in distress and anxiety among sufferers. Understanding the relationship between PE and erectile dysfunction (ED) is critical, as both conditions frequently coexist, with research indicating that men with ED often experience higher rates of PE. This highlights the importance of addressing both issues simultaneously in clinical practice.
Clinical assessments of PE usually rely on measuring the intra-vaginal ejaculation latency time (IELT), which has been shown to specifically indicate the severity of this condition. Current treatment methodologies encompass behavioral strategies and pharmacological treatments, primarily involving selective serotonin reuptake inhibitors (SSRIs) as first-line pharmacotherapy, alongside the utilization of phosphodiesterase type 5 (PDE5) inhibitors like tadalafil and sildenafil. Clinical evidence suggests that PDE5 inhibitors may positively influence PE outcomes, as evidenced by improved IELT scores.
This study aims to contribute to the existing body of literature by exploring the effects of 5mg daily tadalafil treatment on ejaculatory timing, erectile function, and LUTS in a cohort of patients diagnosed with ED.
MATERIALS AND METHODS
A cohort of 60 male patients, all presenting with complaints of erectile dysfunction at the urology clinic from January 2015 to January 2016, was enrolled in the study. Ethical approval was secured from the local ethics committee, and informed consent was obtained from all participants, all of whom were heterosexual and in stable sexual relationships for over six months. Patients were excluded if they had significant neurological disorders, active urinary infections, hormonal imbalances, or had received other ED or PE treatments in the preceding three months.
Demographic data—including age and smoking status—alongside medical history was documented. Erectile function was assessed via the IIEF-5, while PE severity was gauged using IELT measures. Blood samples were drawn following a fasting period to analyze glucose, testosterone, and lipid levels. Subjects were prescribed 5mg of tadalafil daily for three months, with re-evaluations conducted with the same questionnaires to analyze efficacy and side effects.
RESULTS
The study participants' mean age was recorded at 50.4±7.9 years, predominantly presenting with baseline testosterone levels averaging 444.6±178.6 ng/dL, total cholesterol levels of 188.7±29.6 mg/dL, and fasting blood sugar showing 104 (80-360) mg/dL. The pre-treatment scores indicated a mean IELT of 2.2±1.4 minutes, IIEF-5 of 9.5±3.7, and IPSS of 14.1±4.5. In contrast, post-treatment evaluations found IELT at 3.4±1.9 minutes, IIEF-5 improved significantly to 16.1±4.7, while IPSS reduced to 10.4±3.8, showcasing statistically significant results (p<0.001).
DISCUSSION
This study underscores the efficacy of 5mg daily tadalafil in improving ejaculatory timing and alleviating ED symptoms. Prior research correlates PE with ED, suggesting a bidirectional relationship where one condition exacerbates the other. The improvement in IELT and decreases in IPSS scores indicate that daily tadalafil treatment can effectively address both erectile dysfunction and premature ejaculation, potentially due to enhanced blood flow and reduced anxiety related to sexual performance.
While the findings support the use of tadalafil for these conditions, the limitations of the study, including a small sample size and lack of control groups, necessitate further investigation. Future studies are recommended to corroborate these findings and explore the long-term effects of tadalafil treatment on ejaculatory latency and erectile functioning.
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