Role of phosphodiesterase type 5 inhibitors for lower urinary tract symptoms.

Abstract

OBJECTIVE:

To determine the efficacy of phosphodiesterase inhibitors for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH).

DATA SOURCES:

MEDLINE and PubMed were searched from January 1, 2000, to October 31, 2012, using the MeSH terms phosphodiesterase inhibitor, lower urinary tract symptoms, benign prostatic hyperplasia, sildenafil, vardenafil, and tadalafil. Additional articles were obtained from references identified in the original search.

STUDY SELECTION AND DATA EXTRACTION:

English-language randomized controlled trials and review articles were evaluated.

DATA SYNTHESIS:

Men with BPH commonly experience lower urinary tract symptoms (LUTS) such as urgency, frequency, nocturia, and dribbling. α-Adrenergic antagonists have been the mainstay of medical treatment of LUTS but are associated with adverse effects such as orthostatic hypotension, dizziness, and sexual dysfunction. The 5-α reductase inhibitors are associated with sexual dysfunction, and treatment effects may be delayed for 6-12 months. Phosphodiesterase type 5 (PDE-5) inhibitors are effective for the treatment of erectile dysfunction (ED), and large-scale epidemiologic studies suggest a strong link between LUTS and ED. The available PDE-5 inhibitors (sildenafil, tadalafil, and vardenafil) have shown efficacy in the treatment of LUTS in several randomized controlled trials in men with and without concomitant ED.

CONCLUSIONS:

PDE-5 inhibitors consistently reduce LUTS associated with BPH. These medications may offer advantages over conventional therapies such as rapid onset of action, fewer adverse effects, and enhanced sexual function. Quality of life improvements have also been realized in men with BPH who receive PDE-5 inhibitors.

• Authors: Mindi S Miller
• Journal: The Annals of pharmacotherapy (Ann Pharmacother) Vol. 47 Issue 2 Pg. 278-83 (Feb 2013) ISSN: 1542-6270 [Electronic] United States
• PMID: 23386068 (Publication Type: Journal Article, Review)

Chemical References

• Adrenergic alpha-Antagonists
• Carbolines
• Imidazoles
• Phosphodiesterase 5 Inhibitors
• Piperazines
• Purines
• Sulfones
• Triazines
• Vasodilator Agents
• Vardenafil Dihydrochloride
• Tadalafil
• Sildenafil Citrate

Topics

• Adrenergic alpha-Antagonists (adverse effects, therapeutic use)
• Carbolines (adverse effects, therapeutic use)
• Drug Resistance
• Drug Therapy, Combination (adverse effects)
• Erectile Dysfunction (etiology, prevention & control)
• Humans
• Imidazoles (adverse effects, therapeutic use)
• Lower Urinary Tract Symptoms (etiology, prevention & control)
• Male
• Phosphodiesterase 5 Inhibitors (adverse effects, therapeutic use)
• Piperazines (adverse effects, therapeutic use)
• Prostate (drug effects)
• Prostatic Hyperplasia (drug therapy, physiopathology)
• Purines (adverse effects, therapeutic use)
• Randomized Controlled Trials as Topic
• Sildenafil Citrate
• Sulfones (adverse effects, therapeutic use)
• Tadalafil
• Triazines (adverse effects, therapeutic use)
• Vardenafil Dihydrochloride
• Vasodilator Agents (adverse effects, therapeutic use)