Re: Effect of Tadalafil 5 mg on Post-Micturition Dribble in Men with Lower Urinary Tract Symptoms: A Multicentre, Double-Blind, Randomized, Placebo-Controlled Trial
Abstract
available at http://www.ncbi.nlm.nih.gov/pubmed/31207030 Editorial Comment: These authors compare the effect of taking 5 mg tadalafil daily to placebo for 12 weeks in a group of men 20 to 70 years old who had post-micturition dribble and other lower urinary tract symptoms with an International Prostate Symptom Score (IPSS) of 8 or higher and who were regularly sexually active for at least 3 months prior to the study. The study continued for a 12-week double-blind treatment period after a 1-week baseline. Using an outcome indicator (Hallym Post Micturition Dribble Questionnaire) and measuring the IPSS and post-micturition volume for the 87 of 102 patients who completed the followup at 12 weeks, the number of patients whose baseline post-micturition questionnaire decreased by 2 or more points was 68.8% in the treatment group and 31.9% in the placebo group. Post-micturition dribble volume was calculated by weighing a double-folded paper towel attached inside the undergarments immediately after urination and having the patient walk around for 1 minute. Post-micturition volume changed from 0.97 to 0.49 ml in the tadalafil group and from 1.02 to 0.8 ml in the placebo group. The authors offer a few possible hypotheses for why this therapy might be successful, including that it 1) strengthens the urethro-corporocavernosal reflex, 2) acts on the corpus spongiosum and corpus cavernosum to restore elasticity to the sinusoids, possibly correcting a dilated bulbar urethra, and 3)…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 87 participants or records.
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