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The mechanism whereby tadalafil improves the symptoms of BPH is not clear, but phosphodiesterase-5 also is present in the muscles of the bladder and the prostate, and it has been suggested that the relaxation of these muscles may make the passage of urine less difficult, for example, by reducing the pressure Cialis online generic in the muscle surrounding the opening to the urethra that controls the flow of urine from the bladder. Tadalafil was approved by the FDA in November 2003.