The Effect of Vitamin D Replacement in Patients with Lower Urinary Tract Symptoms/Erectile Dysfunction Resistant to Tadalafil 5mg Treatment

Ermec B1, Culha M1, Kocak G2, Canat L1, Otunctemur A1, Altunrende F3

Research Type

Clinical

Abstract Category

Male Sexual Dysfunction

Abstract 418
Transgender Health & Sexual Dysfunction
Scientific Podium Short Oral Session 25
Friday 9th September 2022
16:52 - 17:00
Hall K1/2
Bladder Outlet Obstruction Benign Prostatic Hyperplasia (BPH) Pharmacology Sexual Dysfunction
1. Department of Urology, Prof. Dr Cemil Tascioglu City Hospital, 2. Department of Nephrology, Prof. Dr Cemil Tascioglu City Hospital, 3. Department of Urology, Yuzyil University
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Abstract

Hypothesis / aims of study
The aim of this study was to evaluate the effect of vitamin D replacement in patients with lower urinary tract symptoms (LUTS)/erectile dysfunction (ED) who did not respond to tadalafil 5 mg treatment.
Study design, materials and methods
Patients who applied to the Andrology Clinic with LUTS/ED between September 2017 and August 2020 and used 5 mg Tadalafil daily for treatment and did not benefit from treatment for one month were included in the study. Vitamin D levels of the patients were analyzed and Vitamin D3 100,000 IU/week oral  therapy was administered for a month to the patients with low levels of Vitamin D(<20ng/ml).The values of the patients before and after Vitamin D replacement were compared.
Results
A total of 84 patients were included in the study.The mean age was 49.175±11.63(28-70) years and the mean BMI was 25.93±6.82(18.26-37.87). Testosterone levels of the examined patients were 3.45±0.99 ng/ml. After one month of Vitamin D replacement + Tadalafil 5 mg/d treatment, the IIEF-EF (pre-treatment: 10.73±6.12, post-treatment: 24.18±4.87; p=0.001) and IPSS (pre-treatment: 9.12±7.16, post-treatment: 3.11±1.08; p=0.003) scores of the patients improved significantly. Testosterone levels of the patients increased to 3.77±1.23 ng/ml (p<0.001) and 25(OH)D levels increased to 30.50±7.56 ng/ml (p<0.001).
There was a moderately significant linear correlation between IIEF-EF scores and Vitamin D levels after the treatment (p<0.001; r=0.661) There was a moderate linear correlation between IIEF-EF scores and testosterone levels (p<0.001; r=0.674). There was a moderately significant negative correlation between IIEF-EF scores and IPSS scores after the treatment (p=0.003, r=0.458). A weak positive correlation was found between testosterone levels and Vitamin D levels (p=0.013; r=0.321). There was no significant correlation between IPSS scores and testosterone levels (p=0.356; r=0.221)
Interpretation of results
The study results showed that Tadalafil 5 mg treatment together with Vitamin D replacement had improvement on erectile functions and LUTS in patients with Vitamin D deficiency who took Tadalafil for ED and did not respond. Moreover, it was shown that the improvement in Vitamin D levels was moderately correlated with erectile functions. The results of the present study suggest that the efficacy of Tadalafil increases with Vitamin D replacement administered by examining 25(OH) Vitamin D level in patients who do not respond to Tadalafil 5mg treatment and do no have sufficient improvement in their IIEF-EF scores. It is considered that this is caused by both the efficacy of Vitamin D replacement in the endothelial system and in increasing testosterone levels. There are similar studies in the literature; however, this is the first study, to the best of our knowledge, to evaluate the efficacy of the combined treatment after treatment ineffectiveness.
Concluding message
Low levels of Vitamin D in LUTS/ED patients have an effect on tadalafil non unresponsiveness. With vitamin D supplementation, patients' LUTS and ED symptoms improved. Evaluation of Vitamin D levels is important to improve treatment response, especially in patients who do not respond to PDE-5 inhibitors. Further studies are needed the role of Vitamin D in the pathophysiology of ED.
Disclosures
Funding None Clinical Trial Yes Public Registry No RCT No Subjects Human Ethics Committee Prof. Dr Cemil Tascioglu City Hospital Helsinki Yes Informed Consent Yes
Citation

Continence 2S2 (2022) 100392
DOI: 10.1016/j.cont.2022.100392

20/11/2024 13:05:02