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Penile blood pressure is useful to identify candidates for tadalafil treatment in patients with lower urinary tract symptoms
Author(s) -
Koyama Juntaro,
Kaiho Yasuhiro,
Kawasaki Yoshihide,
Sato Tomonori,
Fukushi Taro,
Kyan Atsushi,
Arai Yoichi
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14456
Subject(s) - tadalafil , medicine , lower urinary tract symptoms , urology , international prostate symptom score , erectile dysfunction , urinary system , prostate , cancer
Objectives To determine whether penile blood pressure (PBP) can be used to identify patients who can benefit from tadalafil treatment, the correlation between PBP at baseline and changes in lower urinary tract symptoms (LUTS) induced by tadalafil treatment was studied prospectively. Patients and Methods Patients with BPH who were poor responders to α 1 ‐blockers and took tadalafil instead of an α 1 ‐blocker were registered between 2014 and 2016. The patients were divided into two groups (low‐ and high‐PBP groups) using the median baseline PBP of 110 mmHg as the threshold. The changes in the International Prostate Symptom Score (IPSS) between before and at 4 and 12 weeks after tadalafil treatment were compared between the low‐ and high‐PBP groups. Multivariate analysis was performed to identify parameters associated with IPSS improvement with tadalafil treatment. Results In all, 51 patients were investigated. The IPSS in the low‐PBP group decreased immediately after the start of treatment, and there was significant improvement in the IPSS from baseline at 4 and 12 weeks after the start of treatment, whilst the IPSS in the high‐PBP group did not show significant changes. On multivariate analysis, PBP at baseline, anticholinergic drug use, and IPSS at baseline were significant predictors of a good IPSS response to tadalafil treatment. Conclusions This study demonstrated that PBP could reliably identify patients with BPH who could benefit from tadalafil treatment. Patients with low PBP could be better responders to tadalafil.