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Daily low-dose tadalafil may reduce the penile curvature progression rate in patients with acute Peyronie’s disease: a retrospective comparative analysis


The aim of this study was to evaluate the clinical outcomes of patients in acute phase of Peyronie’s disease (PD) treated with daily low-dose of Tadalafil. An observational retrospective study involving patients in acute phase of PD with erectile dysfunction (ED) was designed. All subjects were offered Tadalafil 5 mg one tablet a day. Men who accepted treatment were compared to patients who refused Tadalafil. Penile curvature progression was chosen as the primary outcome. PD Questionnaire (PDQ) and IIEF-5 scores were selected as secondary outcomes. A total of 191 patients were included in the study (108 intervention vs. 83 control). Penile curvature progression rate was significantly lower in subjects taking Tadalafil at 12 weeks (25.9% vs. 39.7%, p = 0.042). Mean IIEF-5 score improved in the intervention group, becoming significantly higher compared to the observation group at 12 weeks (19.3 vs. 11.2 points, p < 0.001). Mean PDQ-Overall and PDQ-Penile Pain scores only improved in the intervention group and the statistically significant differences at baseline between groups became not statistically significant at 12 weeks (p = 0.001 vs. p = 0.232 and p < 0.001 vs. p = 0.078, respectively). Daily low-dose Tadalafil in patients with acute phase of PD seems to significantly reduce the penile curvature progression rate compared to observation, especially when it is administrated early. It also appears to improve erectile function and PD-related symptoms.

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Fig. 1: Progression rate of penile curvature according to treatment and PD duration.

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  1. Miner MM, Seftel AD. Peyronie’s disease: epidemiology, diagnosis, and management. Curr Med Res Opin. 2014;30:113–20.

    Article  PubMed  Google Scholar 

  2. Piraino J, Chaudhary H, Ames K, Okoye F 3rd, Sterling M, Clavell-Hernandez J, et al. A consistent lack of consistency in defining the acute and chronic phases of Peyronie’s disease: a review of the contemporary literature. Sex Med Rev. 2022;10:698–713.

    Article  PubMed  Google Scholar 

  3. Punjani N, Nascimento B, Salter C, Miranda E, Terrier J, Taniguchi H, et al. Predictors of Depression in Men With Peyronie’s Disease Seeking Evaluation. J Sex Med. 2021;18:783–8.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mulhall JP, Schiff J, Guhring P. An Analysis of the Natural History of Peyronie’s Disease. J Urol. 2006;175:2115–8.

    Article  PubMed  Google Scholar 

  5. Weidner W, Schroeder-Printzen I, Weiske WH, Vosshenrich R. Sexual Dysfunction in Peyronie’s Disease: An Analysis of 222 Patients Without Previous Local Plaque Therapy. J Urol. 1997;157:325–8.

    Article  CAS  PubMed  Google Scholar 

  6. Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al. European Association of Urology Guidelines on Sexual and Reproductive Health—2021 Update: Male Sexual Dysfunction. Eur Urol. 2021;80:333–57.

    Article  PubMed  Google Scholar 

  7. Fernández-Pascual E, Manfredi C, Cocci A, Quintana Franco LM, Egui Rojo MA, Carballido Rodríguez J, et al. A Novel Penile Splint as Early Traction Therapy After Grafting Techniques for Peyronie’s Disease. J Sex Med. 2020;17:1819–24.

    Article  PubMed  Google Scholar 

  8. Manfredi C, Arcaniolo D, Amicuzi U, Spirito L, Napolitano L, Crocerossa F, et al. Impact of extracorporeal shockwave therapy for erectile dysfunction and Peyronie’s disease on reproductive and hormonal testicular function. Andrology. 2022;

  9. Ferguson JE 3rd, Carson CC 3rd. Phosphodiesterase type 5 inhibitors as a treatment for erectile dysfunction: Current information and new horizons. Arab J Urol. 2013;11:222–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gonzalez-Cadavid NF, Rajfer J. Laboratory Forum: Experimental Models of Peyronie’s Disease. Implications for New Therapies. J Sex Med. 2009;6:303–13.

    Article  CAS  PubMed  Google Scholar 

  11. Chung E, DeYoung L, Brock GB. The Role of PDE5 Inhibitors in Penile Septal Scar Remodeling: Assessment of Clinical and Radiological Outcomes. J Sex Med. 2011;8:1472–7.

    Article  CAS  PubMed  Google Scholar 

  12. Ozturk U, Yesil S, Goktug HNG, Gucuk A, Tuygun C, Sener NC, et al. Effects of sildena fil treatment on patients with Peyronie’s disease and erectile dysfunction. Ir J Med Sci. 2014;183:449–53.

    Article  CAS  PubMed  Google Scholar 

  13. Porst H, Burri A. Current Strategies in the Management of Peyronie’s Disease (PD)—Results of a Survey of 401 Sexual Medicine Experts Across Europe. J Sex Med. 2019;16:901–8.

    Article  PubMed  Google Scholar 

  14. Teloken K. Medical Management of Peyronie’s Disease: Review of the Clinical Evidence. Med Sci. 2019;7:96.

    CAS  Google Scholar 

  15. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA.2013;310:2191.

  16. Rhoden EL, Telöken C, Sogari PR, Vargas Souto CA. The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res. 2002;14:245–50.

    Article  CAS  PubMed  Google Scholar 

  17. Hellstrom WJ, Feldman R, Rosen RC, Smith T, Kaufman G, Tursi J. Bother and distress associated with Peyronie’s disease: validation of the Peyronie’s disease questionnaire. J Urol. 2013;190:627–34.

    Article  PubMed  Google Scholar 

  18. Mulhall JP, Goldstein I, Bushmakin AG, Cappelleri JC, Hvidsten K. Validation of the erection hardness score. J Sex Med. 2007;4:1626–34.

    Article  PubMed  Google Scholar 

  19. Aslam M. Introducing Kolmogorov–Smirnov Tests under Uncertainty: An Application to Radioactive Data. ACS Omega. 2020;5:914–7.

    Article  CAS  PubMed  Google Scholar 

  20. Kim HY. Statistical notes for clinical researchers: Chi-squared test and Fisher’s exact test. Restor Dent Endod. 2017;42:152.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Vardi Y, Levine LA, Chen J, Hatzimouratidis K, Sohn M. Is there a place for conservative treatment in Peyronie’s disease? J Sex Med. 2009;6:903–9.

    Article  PubMed  Google Scholar 

  22. Levine LA, Latchamsetty KC. Treatment of erectile dysfunction in patients with Peyronie’s disease using sildenafil citrate. Int J Impot Res. 2002;14:478–82.

    Article  CAS  PubMed  Google Scholar 

  23. Ferrini MG, Vernet D, Magee TR, Shahed A, Qian A, Rajfer J, et al. Antifibrotic Role of Inducible Nitric Oxide Synthase. Nitric Oxide. 2002;6:283–94.

    Article  CAS  PubMed  Google Scholar 

  24. Valente EGA, Vernet D, Ferrini MG, Qian A, Rajfer J, Gonzalez-Cadavid NF. l-Arginine and phosphodiesterase (PDE) inhibitors counteract fibrosis in the Peyronie’s fibrotic plaque and related fibroblast cultures. Nitric Oxide. 2003;9:229–44.

    Article  CAS  PubMed  Google Scholar 

  25. Palmieri A, Imbimbo C, Creta M, Verze P, Fusco F, Mirone V. Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie’s disease and erectile dysfunction: results from a prospective randomized trial: ESWT and Tadalafil in PD patients. Int J Androl. 2012;35:190–5.

    Article  CAS  PubMed  Google Scholar 

  26. Dell′Atti L. Tadalafil once daily and intralesional verapamil injection: A new therapeutic direction in Peyronie′s disease. Urol Ann. 2015;7:345.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hatampour M, Sohrabi K, Mazdak H, Ghadimi K, Salehi H, Kazemi R. Evaluating the efficacy of intraplaque injection of dexamethasone with oral tadalafil in the chordee patients with Peyronie disease. Am J Clin Exp Urol. 2022;10:25–30.

    PubMed  PubMed Central  Google Scholar 

  28. Gong W, Yan M, Chen J, Chaugai S, Chen C, Wang D. Chronic inhibition of cyclic guanosine monophosphate-specific phosphodiesterase 5 prevented cardiac fibrosis through inhibition of transforming growth factor β-induced Smad signaling. Front Med. 2014;8:445–55.

    Article  PubMed  Google Scholar 

  29. Ilg MM, Stafford SJ, Mateus M, Bustin SA, Carpenter MJ, Muneer A, et al. Phosphodiesterase Type 5 Inhibitors and Selective Estrogen Receptor Modulators Can Prevent But Not Reverse Myofibroblast Transformation in Peyronie’s Disease. J Sex Med. 2020;17:1848–64.

    Article  CAS  PubMed  Google Scholar 

  30. Gonzalez-Cadavid NF, Rajfer J. The two phases of the clinical validation of preclinical translational mechanistic research on PDE5 inhibitors since Viagra’s advent. A personal perspective. Int J Impot Res. 2019;31:57–60.

    Article  CAS  PubMed  Google Scholar 

  31. Garaffa G, Trost LW, Serefoglu EC, Ralph D, Hellstrom WJG. Understanding the course of Peyronie’s disease. Int J Clin Pr. 2013;67:781–8.

    Article  CAS  Google Scholar 

  32. Pryor JP, Ralph DJ. Clinical presentations of Peyronie’s disease. Int J Impot Res. 2002;14:414–7.

    Article  CAS  PubMed  Google Scholar 

  33. Verze P, Capece M, Creta M, La Rocca R, Persico F, Spirito L, et al. Efficacy and safety of low-intensity shockwave therapy plus tadalafil 5 mg once daily in men with type 2 diabetes mellitus and erectile dysfunction: a matched-pair comparison study. Asian J Androl. 2020;22:379.

    Article  CAS  PubMed  Google Scholar 

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Conceptualization: LS, CM; Data Collection: RLR, LN, ADA, MC; Data analysis: FT, CS; Writing-original draft: LS, CM; Scientific review: IS; Supervision: MC, DA.

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Correspondence to Luigi Napolitano.

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Spirito, L., Manfredi, C., La Rocca, R. et al. Daily low-dose tadalafil may reduce the penile curvature progression rate in patients with acute Peyronie’s disease: a retrospective comparative analysis. Int J Impot Res 36, 129–134 (2024).

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