The authors present results of a clinical study examining therapeutic effects of PDE5 inhibitors in the management of male erectile dysfunction following spinal cord injuries. The study was prospective, non-invasive, observational. Aim: The aim of the study was to determine efficacy and safety of tadalafil in the treatment of male erectile dysfunction following spinal cord injuries and to assess one- year treatment results. Material and Methods: 16 males, the mean age of 33 years, participated in a four-week assessment of tadalafil efficacy and safety. A paraplegic couple received 8 tablets of tadalafil 20 mg and recommendation of sexual intercourse twice a week. The males recorded the tablet intake in a „Diary“. The following questionnaire scores were used in the assessment prior and after the four- week treatment period: IIEF-5 (International Index of Erectile Function), GAO (Global Assessment Question), SEP 2 a 3 (Sexual Encountner Profile, questions 2,3). A non- parametric test was used for statistical evaluation. Results: In 94% of the males, the treatment resulted in improved erection quality (GAQ) and there was statistically significant improvement in ability for penis imission to vagina (SEP 2, p = 0.005). In 69% of the young disabled males, tadalafil –mediated erection was sufficient to perform a satisfactory intercourse (SEP3, p = 0.001). Based on the IIEF-5 questionnaire data, the erectile function score improvement was statistically significant, compared to that prior to therapy (p = 0.001). 75% of the paralyzed used the benefit of the long-acting PDE5 inhibitor and repeated the sexual intercourse within 36 hours of its intake. Undesirable effects were reported in 3 out of the 16 subjects and a single patient discontinued the treatment due to the side effects. 8 out of the 16 males (50%) continued the tadalafil treatment after one year of medication. The authors conclude that tadalafil treatment of male erectile dysfunction following spinal cord injuries is safe and effective and is well tolerated for over a year.

        Key words: erectile dysfunction – spinal cord injury – tadalafil