EFFICIENCY OF PHOSPHODIESTERASE-5 INHIBITORS FOR TREATMENT OF LOWER URINARY TRACT SYMPTOMS IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA AND CONCOMITANT ERECTILE DYSFUNCTION


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Lower urinary tract symptoms (LUTS) in combination with benign prostatic hyperplasia and erectile dysfunction are more common than commonly thought. Unfortunately, urologists often don’t ask about concomitant erectile dysfunction in patients with irritative or obstructive symptoms, which leads to the progression of underline disease, a deterioration in the quality of sexual life, and, as a result, overall quality of life. The relevant studies of recent years dedicated to feasibility of using tadalafil 5 mg a day are analyzed in the article. In addition, the results of scientific work conducted on the Department of Urology and Andrology of Faculty of Fundamental Medicine of Lomonosov Moscow State University, whose aim was to study the efficiency of phosphodiesterase-5 inhibitors in patients with LUTS of varying severity in combination with other types of drugs, are presented. Tadalafil in a dose 5 mg leads to a decrease in the severity of LUTS, as confirmed by a decrease in the mean I-PSS score by 2.19 points in the presented studies. No significant changes were found in Qmax (р>0,05). We also proved in our work that phosphodiesterase-5 inhibitor can supplement any combined therapy for benign prostatic hyperplasia in the case of concomitant erectile dysfunction. Tadalafil in a dose 5 mg once a day can be recommended as monotherapy for patients with moderate LUTS caused by benign prostatic hyperplasia with concurrent erectile dysfunction, as an alternative to conventional treatment schemes.

Full Text

Restricted Access

About the authors

A. A Kamalov

Lomonosov Moscow State University

Email: armais.kamalov@rambler.ru
Academician of the RAS, MD, Director of the «University Hospital» of Moscow Research and Education Center, Head of the Department of Urology and Andrology, Faculty of Fundamental Medicine Moscow, Russia

A. N Nizov

Lomonosov Moscow State University

Email: nizovale@gmail.com
Ph.D., urologist at the Moscow Research and Education Center; Junior researcher of the Scientific Department «Urologyand Andrology» of Moscow Research and Education Center Moscow, Russia

References

  1. Yoshimura K., Arai Y., Ichioka K., Terada N., Matsuta Y., Okubo K. Symptom-specific quality of life in patients with benign prostatic hyperplasia. Int J Urol. 2002;9:485-490.
  2. Chapple C.R. BHP Disease Management. Introduction andconcluding remarks. Eur Urol. 1999;36 Suppl 3:1-6.
  3. De Nunzio C., Roehrborn C.G., Andersson K.E., McVary K.T. Erectile Dysfunction and Lower Urinary Tract Symptoms. Eur Urol Focus. 2017;3(4-5):352-363. doi: 10.1016/j.euf.2017.11.004. Epub 2017 Nov 27.
  4. Пушкарь Д.Ю., Камалов А.А., Аль-Шукри С.Х., Еркович А.А., Коган М.И., Павлов В.Н., Журавлев В.Н., Берников А.Н. Эпидемиологическое исследование распространенности эректильной дисфункции в Российской Федерации. Выпуски РМЖ», № 3 от 07.02.2012. С. 112.
  5. Arivazhagan J., Nandeesha H., Dorairajan L.N. et al. Association of elevated interleukin-17 and angiopoietin-2 with prostate size in benign prostatic hyperplasia. Aging Male. 2017;20:115-118.
  6. Giuliano F., Uckert S., Maggi M., Birder L., Kissel J., Viktrup L. The mechanisms of action of phosphodiesterase type 5 inhibitors in the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia. Eur Urol. 2013;63:506-516.
  7. Amano T., Earle C., Imao T. et al. Administration of daily 5mg tadalafil improves endothelial function in patients with benign prostatic hyperplasia. Aging Male. 2017;22:1-6.
  8. Gacci M., Corona G., Salvi M. et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with a-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2012;61:994-1003.
  9. Dong Y., Hao L., Shi Z., et al. Efficacy and safety of tadalafil monotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a metaanalysis. Urol Int. 2013;91:10-18.
  10. Porst H., Roehrborn C.G., Secrest R.J. et al. Effects of tadalafil on lower urinary tract symptoms secondary to benign prostatic hyperplasia and on erectile dysfunction in sexually active men with both conditions: analyses of pooled data from four randomized, placebo-controlled tadalafil clinical studies. J Sex Med. 2013;10:2044-2052.
  11. Pogula V.R., Kadiyala L.S., Gouru V.R., Challa S.R., Byram R., Bodduluri S.adalafil vs. tamsulosin in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: a prospective, randomized study. Cent European J Urol. 2019;72(1):44-50. doi: 10.5173/ceju.2019.1570. Epub 2019 Mar 14.
  12. McVary K.T. Unexpected insights into pelvic function following phosphodiesterase manipulation - what’s next for urology? Eur Urol. 2006;50:1153-1156.
  13. Stief C.G., Porst H., Neuser D., Beneke M., Ulbrich E. A randomised, placebo-controlled study to assess the efficacy of twice-daily vardenafil in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Eur Urol. 2008;53:1236-1244.
  14. Dunn C.J., Matheson A., Faulds D.M. Tamsulosin: A review of its pharmacology and therapeutic efficacy in the management of lower urinary tract symptoms. Drugs Aging. 2002;19:135-161.
  15. Gacci M., Salvi M., Sebastianelli A. et al. The use of a single daily dose of tadalafil to treat signs and symptoms of benign prostatic hyperplasia and erectile dysfunction. Res Rep Urol. 2013;5:99-111.
  16. Park H.J., Won J., Sorsaburu S., et al. Urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) and LUTS/BPH with erectile dysfunction in Asian men: a systematic review focusing on tadalafil. World J Mens Health. 2013;31:193-207.
  17. Calogero A.E., Burgio G., Condorelli R.A., Cannarella R., La Vignera S. Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male. 2018;21(4):272-280. doi: 10.1080/13685538.2018.1432586.
  18. Cho M.C., Paick J.S. A review of the efficacy and safety of mirodenafil in the management of erectile dysfunction. Ther Adv Urol. 2016;8:100-117.
  19. Chung B.H., Lee J.Y., Lee S.H. et al. Safety and efficacy of the simultaneous administration of udenafil and an alpha-blocker in men with erectile dysfunction concomitant with BPH/LUTS. Int J Impot Res. 2009;21:122-128.
  20. Salah Azab S., Elsheikh M.G. The impact of the bladder wall thickness on the outcome of the medical treatment using alpha-blocker of BPH patients with LUTS. Aging Male. 2015;18:89-92.
  21. Тахирзаде А.М. Стратегии комбинированного лечения доброкачественной гиперплазии предстательной железы в зависимости от сопутствующей эректильной дисфункции. Факультет фундаментальной медицины МГУ имени М.В. Ломоносова. М., 2018.
  22. Rosen R.C., Wei J.T., Althof S.E., Seftel A.D., Miner M., Perelman M.A. BPH registry and patient survey steering committee. Association of sexual dysfunction with lower urinary tract symptoms of BPH and BPH medical therapies: results from the BPH Registry. Urology 2009;73:562-566.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies