Single-dose tadalafil, a medication used to treat erectile dysfunction, may have beneficial effects in the treatment of voiding dysfunction in women, according to data presented at the International Continence Society’s 2022 annual meeting (ICS 2022) in Vienna, Austria.

In a randomized, placebo-controlled trial, Thea Christoffersen, MD, of the University of Copenhagen in Denmark, and colleagues evaluated the effects of tadalafil, a phosphodiesterase-type 5 (PDE5) inhibitor, on opening urethral pressure (OUP) in 24 healthy women. The investigators randomly assigned women to receive either a single 40 mg dose of tadalafil or placebo at the first visit and then crossed over to the opposite treatment at the second visit. To avoid carry-over effects, the visits were separated by a washout period of at least 6 days. Using urethral pressure reflectometery, the investigators measured OUP during resting and squeezing of the pelvic floor 2 hours after administration of study treatment, the reported time of peak plasma drug concentration for tadalafil. They performed uroflowmetry with a prefilled bladder volume of 300 mL of natrium chloride immediately following the urethral pressure measurements.

Compared with placebo, tadalafil caused significant decreases of 6.8 cmH2O during resting OUP and 8.8 cmH2O during squeezing, Dr Christoffersen’s team reported. Tadadafil caused no significant change in voiding parameters compared with placebo, including average and maximum flow rate and voiding volume. The investigators observed a significant period effect for average and maximum flow rates, both of which were increased at the second visit compared with the first.

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A total of 41 adverse events occurred (36 related to tadalafil), none of them serious.

“The observed fall in urethral pressure suggests a relaxing effect of PDE5 inhibition on [the external urethral sphincter] and urethral smooth muscle,” the authors concluded.


Christoffersen T, Riis T, Kornholt J, Sonne D, Klarskov N. The effect of single-dose tadalafil on urethral pressure and voiding parameters: a double-blind, randomized, placebo-controlled, crossover study in healthy women. Presented at: ICS 2022, September 7-10, Vienna, Austria. Abstract 3.