title: Management of benign prostatic hyperplasia: role of phosphodiesterase-5 inhibitors.
abstract: Several studies have highlighted a strong association between benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) and erectile dysfunction (ED), particularly in elderly men. Many epidemiological trials, such as in vitro and in vivo studies, have reported the emerging role of metabolic syndrome, including abdominal obesity, impaired glucose metabolism, hypertriglyceridemia, low high-density lipoprotein cholesterol, and hypertension, in the development and progression of urinary and sexual symptoms. Moreover, many authors have focused their studies on the identification of all the shared pathogenetic mechanisms of LUTS/BPH and ED, including alteration of cyclic guanosine monophosphate and RhoA-ROCK pathways or vascular and neurogenic dysfunction. All these are potential targets for proposed phosphodiesterase type 5 inhibitors (PDE5-Is). Therefore, several trials have recently been designed to evaluate the role of PDE5-Is alone or in combination with conventional treatment for BPH, such as α-adrenergic blockers, in men affected by LUTS/BPH, with or without ED. Different PDE5-Is are in clinical use worldwide and currently six of them are licensed for the oral treatment of ED. All these compounds differ in pharmacokinetic factors, with influence on drug action, and subsequently in the overall safety and efficacy profile.
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Viale Pieraccini 18, 50139, Florence, Italy, maurogacci@yahoo.it.
authors.forename: M
authors.initials: M
authors.lastname: Gacci
authors.forename: M
authors.initials: M
authors.lastname: Carini
authors.forename: M
authors.initials: M
authors.lastname: Salvi
authors.forename: A
authors.initials: A
authors.lastname: Sebastianelli
authors.forename: L
authors.initials: L
authors.lastname: Vignozzi
authors.forename: G
authors.initials: G
authors.lastname: Corona
authors.forename: M
authors.initials: M
authors.lastname: Maggi
authors.forename: K T
authors.initials: KT
authors.lastname: McVary
authors.forename: S A
authors.initials: SA
authors.lastname: Kaplan
authors.forename: M
authors.initials: M
authors.lastname: Oelke
authors.forename: S
authors.initials: S
authors.lastname: Serni
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D007172:Erectile Dysfunction / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D058986:Phosphodiesterase 5 Inhibitors