Tadalafil versus solifenacin for persistent storage symptoms after prostate surgery in patients with erectile dysfunction: A prospective randomized study

Objectives: The occurrence of residual storage symptoms after surgical relief of bladder outlet obstruction as a result of benign prostatic enlargement (BPE) underlines the intricate mechanism involved in lower urinary tract symptoms (LUTS). The aim of the present study was to compare tadalafil with solifenacin in modifying symptoms and uroflowmetric parameters in patients with erectile dysfunction (ED) and residual storage symptoms after prostate surgery. Methods: From May 2007 to April 2009, we evaluated 68 patients who had undergone prostate surgery at least 6 months earlier, and presented with ED and persistence of storage symptoms. A total of 56 patients were randomized to receive tadalafil 5 mg (group 1) or solifenacin 5 mg (group 2), both given daily for 12 weeks. International Prostate Symptoms Score (IPSS), IPSS Quality of Life, International Index of Erectile Function-5 (IIEF-5) and uroflowmetry parameters were collected at baseline and after 12 weeks of treatment. Results: A total of 26 patients in group 1 and 25 patients in group 2 completed the study. Each group showed a significant and comparable improvement of urinary symptoms with a decrease of IPSS value. Only in group 1 did the treatment with tadalafil result in a significant increase of IIEF-5. No statistically significant variations were noted in uroflowmetric parameters in both groups. Conclusions: In patients suffering from ED and storage symptoms after surgical treatment for LUTS-BPE, tadalafil 5 mg given once daily for 12 weeks provided a comparable improvement in IPSS to solifenacin 5 mg given for the same period of time.