Effects of tadalafil to prevent injury on corpus cavernosum after vascular or nervous peri-prostatic bundle injury. Experimental model in rats

Toledo, Antônio Carlos de; Kawano, Paulo Roberto; Yamamoto, Hamilto Akihissa; Guerra, Rodrigo; Filho, Fernando Ferreira Gomes; Pajolli, Pedro Ivo Rocchetti; Amaro, João Luiz; Cardoso, Luiz E.M.; Sampaio, Francisco J. B.

doi:10.1590/s0102-865020190090000001

Cited by 1 publication

(2 citation statements)

References 24 publications

(35 reference statements)

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“…26 In some studies, a protective effect of sildenafil due to the activation of antioxidant genes (NnF2, HO-1, and NQ0-1), apoptotic gene (Bcl-2, which has antiapoptotic effect), and attenuation of proinflammatory cytokines like TNF-a, IL-2-b, and ICAM-1 has been found. 10,27,28 Tadalafil has also been used as a protective drug in multiorgan failure syndrome. 29 Several studies have shown that PDE5 inhibitors improve…”

Section: Discussionmentioning

confidence: 99%

“…Tadalafil acts as a protective factor in preventing structural disorganization of the elastic fibers of the corpus cavernosum, reduces the inflammatory response, and assists in the remodeling process. 28,30 PDE-5I have also been used to improve flap survival by improving vascularity in an animal study. 31 Kurt et al 11 used rat models to show urethral strictures could after urethral thermal injury be prevented with the use of tadalafil after urethral thermal injury.…”

Section: Type Of Redo Urethroplastymentioning

confidence: 99%

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Redo pelvic fracture urethral injury repair: The case for tadalafil

Joshi¹,

Desai²,

Fuziwara³

et al. 2021

Turkish Journal of Urology

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Objective: To define the role of tadalafil in improving outcomes of redo urethroplasty for pelvic fracture urethral injury (PFUI). PFUI is common in developing countries, invariably as a result of road traffic trauma. Repair is complex, and redo cases are even more challenging.Material and methods: This was a longitudinal prospective nonrandomized study between 2017 and 2019. Men undergoing redo-urethroplasty were nonrandomized into two groups. Group 1 received tadalafil 5 mg the next day after surgery and continued for 3 months, and group 2 did not receive tadalafil. Inclusion criteria were patients undergoing redo-urethroplasty willing to trial low-dose tadalafil post-operatively. Exclusion criteria were <18 years, females, primary cases, and complex cases such as recto-urethral fistula. Average follow-up was 19.5 months.Results: Sixty patients were enrolled (29 in group 1 and 31 in group 2). Mean age was 31 years. These patients had 1-3 prior failed urethroplasties. Most required step 3 anastomotic urethroplasty (68.3%). Success was defined as absence of symptoms and no need for surgical intervention. Failure was defined as redo urethroplasty or >1 endoscopic intervention. Primary success was 83.3%. Success with tadalafil was 96.6%, compared to 71.0% in the non-Tadalafil group (P ¼ .0008). Only one patient on tadalafil failed, compared with nine in the non-tadalafil group. Secondary success rate was defined as the need for a single subsequent endoscopic intervention and was 93.3%. Conclusion:In our series, there was improved outcome with using tadalafil in patients having redo urethroplasty for PFUI. Further trials should be done to evaluate the use in all PFUI cases.

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