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
Rate of positive urine culture and double–J catheters cclonization on the basis of microorganism DNA analysis
Introduction The aim of the trial was to estimate the relationship between colonization of the Double– J catheter, and the microorganisms cultured from urine. Material and methods 60 patients, who had Double–J catheters...
Letter to the Editor
Letter
Is there a correlation between intravaginal ejaculatory latency time and enuresis? An exploratory study
Introduction Premature ejaculation (PE) is the most common male sexual dysfunction. Monosymptomatic enuresis (ME) is nocturnal bed wetting, without any daytime symptoms. Recent clinical studies report an association betw...
What is the best urinary diversion after laparoscopic radical cystectomy?
Bez streszczenia (Editorial)
Do urologists need an orthodontist in order to optimize the treatment of nocturnal enuresis?
Editorial. The article does not have an abstract.