title: Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH-LUTS.
abstract: Benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) and erectile dysfunction commonly coexist, and both respond to phosphodiesterase (PDE) 5 inhibitors, suggesting a shared pathophysiological mechanism. We propose that both BPH-LUTS and erectile dysfunction are caused by microvascular dysfunction within the pelvic organs, and we present an overview of preclinical and clinical studies supporting the hypothesis that, within both the penis and the lower urinary tract, a combination of endothelial and neural dysfunction leads to a vicious cycle of hypoxia, vasoconstriction, altered smooth muscle contractility, and degeneration of autonomic neurons and ganglia. This hypothesis explains much of the preclinical and clinical research relating to these two conditions, and provides a rationale for further investigation into the effects of PDE5 inhibitors on the pathophysiology and symptoms of BPH-LUTS.
authors.affiliation: Cranfield University, Bedfordshire MK43 0AL, UK.
authors.forename: Selim
authors.initials: S
authors.lastname: Cellek
authors.affiliation: School of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK.
authors.forename: Norman E
authors.initials: NE
authors.lastname: Cameron
authors.affiliation: School of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Cotter
authors.affiliation: Department of Physiology and Pharmacology, University of Bristol, Medical Sciences Building, University Walk, Bristol BS8 1TD, UK.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Fry
authors.affiliation: Lilly UK, Lilly House, Priestley Road, Basingstoke, Hampshire RG24 9NL, UK.
authors.forename: Dapo
authors.initials: D
authors.lastname: Ilo
mesh_terms: D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D055806:Microvessels; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy*; D014652:Vascular Diseases / Q000150:complications*
chemical_list: D058986:Phosphodiesterase 5 Inhibitors