PDE5 inhibitors for LUTS.
To review the current literature regarding the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), and the role of phosphodiesterase-5 (PDE5) inhibitors for the treatment of LUTS. Review of recently published (1990-2009) data regarding epidemiologic and pathophysiologic mechanisms are involved in LUTS-ED, focusing on PDE5 inhibitors particularly evidenced from level 1 clinical trials. Search terms included phosphodiesterase inhibitors, nitric oxide, autonomic hyperactivity, Rho-kinase, atherosclerosis, LUTS, benign prostatic hypertrophy, and ED. Results of several epidemiologic studies show a possible causal relationship between LUTS and ED. Four possible mechanisms have been proposed to explain this association. Multiple large clinical trials have shown a benefit in LUTS after PDE5-inhibitors treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment.
Mouli
S
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Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
McVary
K T
KT
D000368:Aged; D000375:Aging; D000818:Animals; D050197:Atherosclerosis / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology; D002986:Clinical Trials as Topic; D006152:Cyclic GMP / Q000502:physiology; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5 / Q000378:metabolism*; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000502:physiology; D019001:Nitric Oxide Synthase / Q000502:physiology; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D011467:Prostate / Q000502:physiology; D011470:Prostatic Hyperplasia / Q000188:drug therapy; D053448:Prostatism / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D054460:rho-Associated Kinases / Q000378:metabolism
D010726:Phosphodiesterase Inhibitors; D009569:Nitric Oxide; D019001:Nitric Oxide Synthase; D054460:rho-Associated Kinases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D006152:Cyclic GMP