The new horizons of pharmacotherapy. Unexpected pharmacological actions and a new therapeutic strategy of phosphodiesterase–5 inhibitors
Journal Title: Central European Journal of Urology - Year 2014, Vol 67, Issue 3
Abstract
Introduction Benign prostate hyperplasia and erectile dysfunction affect a significant subset of men. BPH and ED may have the same promoting conditions and are the strong predicting risk factors to each other. A significant number of these patients are bothered by lower urinary tract symptoms (LUTS). Direct correlation of age, sexual dysfunction and LUTS severity has been well documented. Many sexually dysfunctional patients with concomitant BPH receive alpha–adrenergic antagonists and any Phosphodiesterase–5 (PDE5) inhibitor simultaneously. PDE5 inhibitors relieve LUTS symptoms in the course of BPH and reduce independent detrusor contractions. This paper presents the results of clinical trials on the efficacy of PDE5 inhibitors on LUTS, new perspectives on its use and newly–identified side effects. Material and methods The review is based on an internet search of PubMed and Medscape databases. The search terms were as follows: LUTS and ED, BPH and phosphodiesterase–5 inhibitors, LUTS clinical trials, phosphodiesterase–5 inhibitors mechanisms. Results Clinical trials show an epidemiological and pathophysiological relationship between BPH, LUTS and ED. Numerous studies reveal the alleviating effect of phosphodiesterase–5 inhibitors on LUTS, expressed as the reduction of IPSS score, but not followed by a change in Qmax. Opponents raise a link of PDE5 inhibitors with increased risk of melanoma. New studies reveal that phosphodiesterase–5 inhibitors are effective in the treatment of neurological disorders. Conclusions Researches reveal the efficacy of phosphodiesterase–5 inhibitors in LUTS along with an improvement of erectile function. The molecular mechanism of action of such drugs suggests imminent novel applications. Potential benefits will be multidimensional. Unfortunately, interfering with particular molecular mechanism
Authors and Affiliations
Stanisław Wroński
Keywords
Related Articles
- EP ID EP356505
- DOI 10.5173/ceju.2014.03.art20
- Views 59
- Downloads 0
Lower urinary tract symptoms and their severity in men subjected to prostate biopsy
Introduction Lower urinary tract symptoms (LUTS) are one of most frequent complaints among men over 50 years of age. They usually result from benign prostate hyperplasia, which often coexists with cancer. The aim of the...
Does diabetes affect the distribution and number of interstitial cells and neuronal tissue in the ureter, bladder, prostate, and urethra of humans?
Introduction The aim of this study was to investigate and compare the distribution and number of interstitial cells (ICs) and neuronal tissue in the ureter, bladder, prostate, and urethra of human patients with and witho...
Pattern of prostate cancer presentation among the Egyptian population: A study in a single tertiary care center
Introduction Prostate cancer is a common health problem that in the majority of cases starts to develop at the age of 50 years, reaching its peak at 60–70 years of age. A variation in its incidence and prevalence exists...
Tadalafil in the management of lower urinary tract symptoms: a review of the literature and current practices in Russia
Introduction Strong epidemiologic evidence supports correlation between lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) and erectile dysfunction (ED). The link has biologic plausibility given...
Infected urachal cyst in a young adult
The urachus is the remnant of the cloaca, which in adults attaches the bladder dome to the umbilicus. After birth it obliterates and presents as the midline umbilical ligament. Patent urachal anomalies are usually detect...