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Role of tadalafil in enhancing visualization of posterior urethra prior to combined voiding cystourethrogram and retrograde urethrogram: a retrospective analysis

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Abstract

Purpose

To show utility of tadalafil in enhancing visualization of posterior urethra in patients with urethral stricture.

Methods

We retrospectively reviewed the records of adults male who failed to delineate the posterior urethra while undergoing combined voiding cystourethrogram and retrograde urethrogram (VCUG and RUG), as a part of preoperative assessment of stricture length and location before urethral reconstruction.

The study was repeated 24 h later after a single dose of tadalafil 20 mg was administrated 2 h before the procedure (Tadalafil group). A control group who did not receive any medication was used for comparison (control group). This study was carried out in between March 2016 and August 2019.

Results

Thirty patients were included in the tadalafil group and equal number of patients was used as control group for comparison. The etiologies of strictures were pelvic fracture urethral distraction defect (39 patients), bulbar stricture with complete obliteration (15 patients) and post catheterization (6 patients).

Success rate of opening bladder outlet on initiation of voiding was 90% in tadalafil group and 40% in the control group (P = 0.0004). None of the men reported any serious adverse events after oral administration of the drug. Almost all AEs were mild and well-tolerated.

Conclusion

Tadalafil effectively relaxes the bladder neck and the posterior urethra prior to combined VCUG and RUG in urethral stricture patients. Tadalafil was safe with no serious adverse effects when administered prior to performing the test. This prevents the patients from undergoing further invasive or expensive diagnostic techniques, moreover, tadalafil assisted in preoperative surgical preparation and patient's counseling.

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Abbreviations

VCUG:

Combined voiding cystourethrogram

RUG:

Retrograde urethrogram

PFUDD:

Pelvic fracture urethral distraction defect

PDE5-Is:

Phosphodiesterase type 5 inhibitors

ED:

Erectile dysfunction

LUTS:

Lower urinary tract symptoms

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Funding

The study did not receive any funding.

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Authors and Affiliations

  1. Alexandria University, Alexandria, Egypt

    Ahmed Fahmy, Omar Elgebaly, Moustafa Momtaz Elsawy & Samir Orabi

Authors
  1. Ahmed Fahmy
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  2. Omar Elgebaly
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  3. Moustafa Momtaz Elsawy
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  4. Samir Orabi
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Corresponding author

Correspondence to Ahmed Fahmy.

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Conflict of interest

All authors declare no conflict of interest related to this study.

Ethical approval

The published article complies with the guidelines for human studies and was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. Approval for the study was obtained from the Alexandria Faculty of Medicine ethical committee (File number and date, 128:06-2016).

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Fahmy, A., Elgebaly, O., Elsawy, M.M. et al. Role of tadalafil in enhancing visualization of posterior urethra prior to combined voiding cystourethrogram and retrograde urethrogram: a retrospective analysis. Abdom Radiol 46, 4332–4337 (2021). https://doi.org/10.1007/s00261-021-03109-5

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  • DOI: https://doi.org/10.1007/s00261-021-03109-5

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