Tadalafil, a Phosphodiesterase-5 Inhibitor, Improves Erectile Dysfunction in Patients With Liver Cirrhosis.

BACKGROUND

Erectile dysfunction(ED) is common in patients with chronic liver disease(CLD). Although it significantly worsens the quality of life, caregivers and researchers often neglect it.

AIM

Evaluating the prevalence of ED in patients with CLD, associated factors, and response to therapy with tadalafil, a phosphodiesterase-5 inhibitor.

METHODS

A total of 60 males with Child-Pugh score between 5 and 10 and no overt hepatic encephalopathy were studied. ED was assessed based on the 15-question International Index of Erectile Function (IIEF) questionnaire. Patients were classified as ED+ if score was <25. Patients with ED were given 10 mg of tadalafil for 4 weeks.

RESULTS

The mean age was 45.2 he 7.8 years. The mean Child-Turcotte-Pugh (CTP) score was 6.4 sc 1.7, and model for end-stage liver disease (MELD) score was 12.1 sc 4.5. Twenty-seven (45%) patients had compensated cirrhosis, and 45(75%) had alcohol as etiology. Twenty-five (42%) had an IIEF score <25, suggestive of ED. The IIEF score had significant correlation with the presence of ascites(r = -0.27, 0.04) and serum creatinine (r -0.26,  = 0.05); however, there was no correlation with CTP, MELD, or alcohol as etiology. Among ED group, IIEF scores improved significantly with 4 weeks of tadalafil therapy (15.1 ± 5.6 vs 22.0 ± 3.4,  < 0.001), and 11(44%) had resolution of ED.

CONCLUSION

ED is common in patients with cirrhosis. Tadalafil administration significantly improves ED in these patients.