Evidence map›Paper›PMID 42096062›Full record

Trial reportInternational urogynecology journal2026

Comparative Efficacy of Tadalafil and Amitriptyline in Female Interstitial Cystitis/Bladder Pain Syndrome: Double-Blind Randomized Trial.

Noran N Makled, Mirhan N Makled, Tamer E Helmy, Mahmoud R El-Kenawy, Ahmed S El-Hefnawy

Abstract readRandomized Controlled TrialComparative Study
PubMed Publisher
In one paragraph

Trial report in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Noran N MakledUrology Department, Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Dakahlia Governorate, Mansoura, 7650030, Egypt.
Mirhan N MakledPharmacology and Toxicology Department, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.
Tamer E HelmyUrology Department, Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Dakahlia Governorate, Mansoura, 7650030, Egypt.
Mahmoud R El-KenawyUrology Department, Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Dakahlia Governorate, Mansoura, 7650030, Egypt.
Ahmed S El-HefnawyUrology Department, Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Dakahlia Governorate, Mansoura, 7650030, Egypt. a_s_elhefnawy@yahoo.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisInterstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic debilitating disorder of unclear etiology that impairs quality of life; physically, emotionally, and sexually. Up till now, no standard effective therapy has existed. Phosphodiesterase-5 inhibitors are vasodilatory and anti-inflammatory. We studied the efficacy and safety of tadalafil, amitriptyline, and their combination in female IC/BPS patients.

methodsIn this study, 132 female patients were randomized into three groups. Assessments were performed at baseline and at 4, 8, and 12 weeks using voiding diary, uroflowmetry, the visual analog scale (VAS), the Interstitial Cystitis Symptom Index (ICSI), and the Interstitial Cystitis Problem Index (ICPI). Global Response Assessment (GRA) and correlations between VAS and voided volume were analyzed at the end. Statistical analysis was performed using the Kruskal-Wallis test.

resultsTadalafil and combination improved daytime voids more than amitriptyline (tadalafil vs amitriptyline p = 0.0005, amitriptyline vs combination p < 0.0001, tadalafil vs combination p = 0.0009). Night-time voids improved notably in tadalafil and combination vs amitriptyline (p < 0.0001). Maximum urinary flow rate (Qmax) increased in combination and tadalafil vs amitriptyline (p = 0.0004) and (p = 0.0294) respectively. Voided volume was higher in combination vs amitriptyline (p = 0.0041). ICSI, ICPI, and VAS scores decreased in all groups (p < 0.0001). Ninety-two patients achieved a GRA score of 7. VAS correlated with voided volume in the tadalafil group (r = -0.60). Amenorrhea was the most bothering adverse event among the patients in the tadalafil group.

conclusionsTadalafil, alone or combined with low-dose amitriptyline, is a safe and effective treatment for female IC/BPS. The combination had comparable or superior efficacy to tadalafil using a lower amitriptyline dose while reducing adverse events.

Indexed as

AmitriptylineCystitis, InterstitialPhosphodiesterase 5 InhibitorsTadalafilAdultDouble-Blind MethodDrug Therapy, CombinationFemaleHumansMiddle AgedTreatment OutcomeAmitriptylinePhosphodiesterase 5 InhibitorsTadalafilAmitriptylineChronic pelvic painFemale bladder pain syndromeInterstitial cystitisLower urinary tract symptomsTadalafil

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.