Objectives: To investigate the efficacy of tadalafil for patients with benign prostatic hyperplasia and especially with chronic prostatitis/chronic pelvic pain syndrome.Methods: Tadalafil 5 mg was given each morning for 12 weeks to patients diagnosed as having either moderate or severe lower urinary tract symptoms. Voiding symptoms were compared between patients with a high (>4; high group) and low (<4; low group) pain subscore of the National Institutes of Health Chronic Prostatitis Symptom Index before and after tadalafil administration. Correlation between changes in the Chronic Prostatitis Symptom Index and the International Prostate Symptom Score during treatment was also investigated.Results: At the pretreatment baseline, the pain subscore of the Chronic Prostatitis Symptom Index was high (>4) in 24 of 74 (32.4%) patients. The International Prostate Symptom Score in the group with high pain subscore was significantly higher than that in the group with low pain subscore. As an indicator of the efficacy of tadalafil, the International Prostate Symptom Score and National Institutes of Health Chronic Prostatitis Symptom Index total score and pain subscore were significantly improved.The change in the Chronic Prostatitis Symptom Index total score correlated positively with the change in the International Prostate Symptom Score. The decrease in the 4 International Prostate Symptom Score was significantly greater in the group with high versus low pain subscore. Conclusion:Tadalafil was sufficiently effective in the treatment of patients with benign prostatic hyperplasia and severe chronic prostatitis/chronic pelvic pain syndrome.

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Objectives: To clarify the efficacy of low-intensity extracorporeal shockwave therapy for patients with erectile dysfunction, compare the efficacy between two types of lithotripters (ED1000 [focused type] and Renova [linear type]), and detect factors indicative of therapeutic gain with the treatment. Methods: This retrospective study included 76 patients (52.8 AE 11.7 years) treated by ED1000 (12 times over 9 weeks) and 484 patients (52.5 AE 11.6 years) treated by Renova (4 times over 4 weeks). Age, sexual symptoms scores, and blood examinations were assessed. Efficacy was judged by improvement of the scores and patient satisfaction and compared between patients at 1 month after treatment with the lithotripters. Independent factors influencing efficacy by Renova were also assessed. Results: Sexual symptom scores were improved significantly by both lithotripters, although the changes in the scores did not differ significantly between them. Efficacy rate as judged by patient satisfaction was 65.8% with the ED1000 and 71.1% with Renova, also without significant difference. Among several factors including age, sexual symptoms scores, endocrinological factors, metabolic factors, and the rate of phosphodiesterase type 5 inhibitor use, only age was found to be an independent factor influencing the efficacy of Renova. Conclusion:We clearly showed the high efficacy of both lithotripters. Although the efficacy rate did not differ between them, we speculated that the fewer treatment sessions needed with the Renova versus the ED1000 would be a great advantage for patients. We also suggest that Renova should be recommended for patients younger than 70 years of age.

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