Introduction: Daily tadalafil 5 mg provides a valuable alternative to on-demand tadalafil for men who prefer spontaneous to scheduled sexual attempts. We investigated the rate of and the clinical factors associated with erectile function (EF) recovery after discontinuation of 5 mg tadalafil OaD in a cohort of young men seeking medical help for ED as primary complaint. Methods: Data from 96 consecutive young patients ( <50 yr) with ED and prescribed with 5 mg tadalafil OaD were analysed. All patients were diagnosed with psychogenic ED after a comprehensive clinical evaluation including penile duplex ultrasound and hormonal profile assessment. All completed the International IIEF at baseline. Length of treatment varied from 1 to 12 months according to clinical judgement. EF recovery was assessed after 2 weeks from treatment discontinuation and defined as IIEF-EF>21 after daily 5 mg tadalafil discontinuation. Patients without EF recovery were classified as tadalafil OaD non-responders. Cox-regression models tested the association between patients' baseline characteristics and the probability of EF recovery after treatment discontinuation. Kaplan-Meier analyses estimated the probability of EF recovery over time. Results: Median (IQR) age was 39 (32-45) yr. Of all, 82 (85.4%) achieved EF recovery at treatment discontinuation, whilst 14 (14.6%) were identified as non-responders. Median treatment length was 3 (2-11) months. Most common treatment-related adverse effect was headache in 9 (9.4%) patients. Non-responders were older (43 vs. 38, p=0.03), with higher BMI (25.54 vs. 23.6, p=0.04) and depicted lower IIEF-EF scores at baseline (12 vs. 15, p=0.02) than responders. No differences in terms of comorbidities (CC=1), smoking, alcohol consumption and regular physical exercise were detected. Kaplan Meier estimates of EF recovery at 3, 6 and 12 months, were 43% (95%CI: 41-62), 60% (95%CI: 49-69) and 75% (95%CI: 64-83), respectively (Fig. 1). Younger age (HR: 0.95; 95% CI: 0.92-0.99, p=0.01) was associated with EF recovery after adjusting for baseline EF, BMI, smoking and CCI=1. Conclusions: Almost one out of two young ED patients prescribed with tadalafil OaD achieved full EF recovery within 3 months of treatment. Younger patients have higher probability of EF recovery with daily 5 mg tadalafil therapy. SOURCE OF Funding: .
