The aim of the study was to assess the efficacy and safety of taking tadalafil at a dose of 5 mg per day or 20 mg «on demand» for the state of endothelial function, the severity of erectile dysfunction (ERD) and urodynamics in men with mild to moderate ERD.
Materials and Methods: The study included 60 male patients with benign prostatic hyperplasia aged 44 to 60 years with erectile dysfunction and cardiovascular pathology (arterial hypertension, ischemic heart disease). All patients were divided into 3 groups of 20 people. Patients of the 1st group for the treatment of ERD were prescribed tadalafil (Tadalafil SZ, NAO Severnaya Zvezda) in a daily dose of 5 mg / day. Men of the 2nd group took tadalafil 20 mg “on demand”, but at least 1 time per week. The third group, in which tadalafil was not prescribed, served as a control. The duration of the study was 4 weeks.
Results: A significant effect of tadalafil on indicators of endothelial dysfunction (endothelin-1, nitric oxide, stiffness and reflection index, endothelial function indicator) was demonstrated. The use of tadalafil at a dose of 5 mg daily for four weeks has been shown to be advantageous compared to the use of 20 mg “on demand”. Daily intake of tadalafil at a dose of 5 mg and 20 mg «on demand» was safe for patients with cardiovascular disease.
Conclusion. The data obtained make it possible to recommend this drug for the correction of endothelial dysfunction in patients with benign prostatic hyperplasia, including patients with concomitant cardiovascular diseases.

Keywords: MIEF-5, endothelial function index, stiffness and reflection index, IPSS, uroflowmetry, nitric oxide, tadalafil, endothelin-1