Phosphodiesterase-5 inhibitors and benign prostatic hyperplasia.
OBJECTIVE
Benign prostatic hyperplasia (BPH) is prevalent in old men and often results in lower urinary tract symptoms (LUTS). Phosphodiesterase-5 (PDE5) inhibitors increase intracellular concentrations of cyclic guanosine monophosphate. PDE5 inhibitors (sildenafil, tadalafil, vardenafil, etc.) are first-line treatments for erectile dysfunction. Recently, PDE5 inhibitors have been found to regulate smooth muscle tone in human prostate. This article focuses on the use of PDE5 inhibitors for BPH/LUTS treatment and highlights the clinical significance.


RESULTS
Preclinical and clinical studies have provided promising evidence that PDE5 inhibitors may be an effective and well tolerated treatment option for BPH/LUTS. Combination therapy using PDE5 inhibitors and alpha1-adrenergic blockers resulted in greater improvements in BPH/LUTS than did either drug alone.


CONCLUSIONS
There has been increasing interest in the use of PDE5 inhibitors to treat BPH/LUTS. Combination of PDE5 inhibitors and alpha1-adrenergic blockers may have an additive beneficial effect on BPH/LUTS compared with monotherapy. Mechanisms of action of nitric oxide/cyclic guanosine monophosphate/PDE5 pathway in the treatment of BPH/LUTS deserve further investigations. Larger-scale, well designed clinical trials in future are needed to ascertain the safety, efficacy and cost-effectiveness of PDE5 inhibitors in the treatment of LUTS secondary to BPH.
Wang
Chunyu
C
Baylor College of Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. chunyuwang2000@gmail.com
D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy*; D053448:Prostatism / Q000188:drug therapy* / Q000209:etiology; D016032:Randomized Controlled Trials as Topic
D058986:Phosphodiesterase 5 Inhibitors