Introduction: Tadalafil 5 mg once daily (T5od) has been recently approved by the Food and Drug Administration for the treatment of lower urinary tract symptoms (LUTS), along with erectile dysfunction (ED). Recent pooled data analyses demonstrated that T5odInternational Prostate Symptom Score related improvements were significant regardless of confounders. In addition, PDE5 inhibitors exert a positive effect on ejaculatory latency. We assessed the clinical outcome of 30 days-T5od administration on a patient complaining of CPPS/LUTS.
Case report: A Caucasian men of 27 years presented for chronic pelvic pain syndrome (CPPS) and LUTS. He has been complaining since one month of CPPS, LUTS, mild ED and acquired premature ejaculation. He underwent, before and after treatment, medical history assessment, complete physical examination, scrotal and transrectal color-Doppler ultrasound (CDUS) before and after ejaculation, semen analysis including seminal interleukin 8 (sIL8) measurement, and validated questionnaires exploring CPPS (National Institutes of HealthChronic Prostatitis Symptom Index (NIHCPSI)), LUTS (International Prostate Symptom Score (IPSS)), sexual and erectile function (International Index of Sexual Function-15, (IIEF-15) and (IIEF-15erectile function domain (EFD) respectively), ejaculatory status (Premature Ejaculation Diagnostic Tool PEDT) and psychological symptoms (Middlesex Hospital Questionnaire). After treatment the patient showed an improvement in NIH-CPSI (22→17) and IPSS (23→14) scores. Global sexual and erectile functions, assessed by IIEF-15 (58→68) and IIEF-15-EFD (24→27) respectively, improved, as well as ejaculatory latency (PEDT score 14→11). Psychological status, assessed by MHQ, showed a consistent amelioration (19→7) at the end of the treatment. We also observed an improvement in biochemical and CDUS parameters related to prostate-vesicular inflammation. In particular, a reduction in sIL8 levels (8.15→6.14 ng/ml) and a significant improvement in arterial peak systolic velocity (12.7→6.8 cm/s), parameters related to prostate inflammation and CPPS, were observed after treatment.
Conclusion: A 30 days-T5od administration seems to exert an improvement in CPPS/LUTS, biochemical and CDUS parameters of prostate inflammation, along with psycho-sexual function.