CURRENT APPROACHES TO CONSERVATIVE TREATMENT OF MEN WITH CONCOMITANT BENIGN PROSTATIC HYPERPLASIA AND ERECTILE DYSFUNCTION


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Abstract

The article reviews the results of various conservative treatments for concomitant benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). Phosphodiesterase type 5 (PDE5) inhibitors remain the first-line therapy for this category of patients taking into account their positive effect on both ED and BPH. The preferred treatment scheme includes PDE-5 inhibitor co-administered with a1-adrenoblocker. However, other combination treatments are considered promising, for example, a PDE-5 inhibitor with a 5a-reductase inhibitor or a three-component treatment regimen: α1-adrenoblocker + 5α-reductase inhibitor + PDE-5 inhibitor. All these approaches to treating patients with BPH and ED have demonstrated high efficiency and safety. Nevertheless, a limited number of randomized clinical trials and short-term observations suggest the need for further studies investigating the long-term outcomes of different treatment options for such patients.

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About the authors

A. A Kamalov

Lomonosov MSU

Academician of the RAS, Dr.Med.Sci., Prof., Head of the Department of Urology and Andrology, Faculty of Fundamental Medicine; Director Moscow, Russia

A. M Takhirzade

Lomonosov MSU

Email: anar391@rambler.ru
Ph.D. Student at the Department of Urology and Andrology, Faculty of Fundamental Medicine Moscow, Russia

References

  1. Gacci M., Eardley I., Giuliano F., Hatzichristou D., Kaplan S.A., Maggi M., McVary K.T., Mirone V., Porst H., Roehrborn C.G. Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2011;60(4):809- 825.
  2. Laumann E.O., Paik A., Rosen R.C. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281(6):537-544.
  3. Blanker M.H., Bohnen A.M., Groeneveld F.P., Bernsen R.M., Prins A., Thomas S., Bosch J.L. Correlates for erectile and ejaculatory dysfunction in older Dutch men: a community-based study. J Am Geriatr Soc. 2001;49(4):436-442.
  4. Rosen R., Altwein J., Boyle P., Kirby R.S., Lukacs B., Meuleman E., O’Leary M.P., Puppo P., Robertson C., Giuliano F. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003;44(6):637-649.
  5. Corona G., Gacci M., Maseroli E., Rastrelli G., Vignozzi L., Sforza A., Forti G., Mannucci E., Maggi M. Clinical correlates of enlarged prostate size in subjects with sexual dysfunction. Asian J Androl. 2014;16(5):767-773.
  6. Kardasevic A., Milicevic S. The Correlation Between Prostate Volume in Patients with Benign Prostatic Hyperplasia in Relation to Erectile Dysfunction. Med Arch. 2016;70(6):449-452.
  7. Shimizu S., Tsounapi P., Shimizu T., Honda M., Inoue K., Dimitriadis F., Saito M. Lower urinary tract symptoms, benign prostatic hyperplasia/ benign prostatic enlargement and erectile dysfunction: are these conditions related to vascular dysfunction? Int J Urol. 2014;21(9):856-864.
  8. Glina S., Glina F.P. Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction. Ther Adv Urol. 2013;5(4):211-218.
  9. Kirby M., Chapple C., Jackson G., Eardley I., Edwards D., Hackett G., Ralph D., Rees J., Speakman M., Spinks J., Wylie K. Erectile dysfunction and lower urinary tract symptoms: a consensus on the importance of co-diagnosis. Int J Clin Pract. 2013;67(7):606-618.
  10. Kalinina S.N., Koren’kov D.G., Fesenko V.N., Zamyatnin S.A., Demidov D.A., Tsygankov A.V., Tiktinskii N.O., Kakhorov Kh.Kh. Diagnosis and treatment of erectile dysfunction in patients with benign prostatic hyperplasia. Andrologiya i genital’naya khirurgiya. 2016; 17( 1) ;49-59.
  11. Korneev I.A. Sildenafil Citrate Dose Adjustment for Men with Erectile Dysfunction: Personalized Approach. Urologiia. 2015;4:108-11
  12. Petrichko M.I., Volkov A.A., Budnik N.V., Dukhin A.R. Assessment of symptoms of the lower urinary tract and erectile dysfunction as the basis of quality of life in patients with BPH before initiating drug therapy. Dal’nevostochnyi meditsinskii zhurnal. 2012;1:51-55
  13. Kalinina S.N., Koren’kov D.G., Fesenko V.N. Diagnosis and treatment of erectile dysfunction in patients with benign prostatic hyperplasia. Special issue: Proceedings of the 3rd scientific and practical conference of urologists of the North-West Federal District of the Russian Federation: April 20-21 2017, Sankt-Peterburg. Urologicheskie vedomosti. 2017;7:43-44
  14. Govorov A.V., Kasyan G.R., Vasil’ev A.O., Pushkar D.Yu. adalafil in the treatment of symptoms from the lower urinary tract: a review of literature and existing clinical practice in Russia. Consilium Medicum. 2014;16(7):33-41.
  15. Kamalov A.A., Okhobotov D.A., Takhirzade A.M., Osmolovskii B.E., Takhirzade T.B., Gevorkyan A.R. Combination therapy of patients with symptoms ofthe lower urinary tract and erectile dysfunction. Estestvennye i tekhnicheskie nauki. 2013;1:105-13.
  16. Gacci M., Andersson K.E., Chapple C., Maggi M., Mirone V., Oelke M., Porst H., Roehrborn C., Stief C., Giuliano F. Latest Evidence on the Use of Phosphodiesterase Type 5 Inhibitors for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. Eur Urol. 2016;70(1):124-133.
  17. Zhang L.T., Park J.K. Are phosphodiesterase type 5 inhibitors effective for the management of lower urinary symptoms suggestive of benign prostatic hyperplasia? World J Nephrol. 2015;4(1):138-147.
  18. Zhang W.H., Zhang X.H. Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update. Asian J Androl. 2016;18(5):723-731.
  19. Martazinova S.K., Shcheplev P.A. Efficacy and safety of combined use of alpha1-adrenoblocker doxazosin and phosphodiesterase 5 type inhibitor udenafil in patients with benign prostatic hyperplasia. Andrologiya i genital’naya khirurgiya. 2013;2:69-73
  20. Lee L.K., Goren A., Boytsov N.N., Donatucci C.F., McVary K.T. Treatment satisfaction among men with concurrent benign prostatic hyperplasia and erectile dysfunction treated with tadalafil or other phosphodiesterase type-5 inhibitor combinations. Patient Prefer Adherence. 2016;10:1205-1215.
  21. Kamalov A.A., Osmolovskii B.E., Okhobotov D.A., Khodyreva L.A., Takhirzade T.B., Takhirzade A.M., Gevorkyan A.R. Combined treatment ofpatients with erectile dysfunction and disorders of urination. Urologiia. 2013;3:29-
  22. Russian (Камалов А.А., Осмоловский Б.Е., Охоботов Д.А., Ходырева Л.А., Тахирзаде Т.Б., Тахирзаде А.М., Геворкян А.Р. Комбинированное лечение больных эректильной дисфункцией, страдающих расстройствами мочеиспускания. Урология. 2013; 3:29-33).
  23. Tomilov A.A., Golubtsova E.N. Combined treatment of patients with lower urinary tract symptoms and erectile dysfunction. Urologiia. 2013;5:64-69. Томилов А.А., Голубцова Е.Н. Комбинированное лечение больных с симптомами нижних мочевыводящих путей и эректильной дисфункцией. Урология. 2013;5:64-69.
  24. Wang X.H., Wang X., Shi M.J., Li S., Liu T., Zhang X.H. Systematic review and meta-analysis on phosphodiesterase 5 inhibitors and α-adrenoceptor antagonists used alone or combined for treatment of LUTS due to BPH. Asian J Androl. 2015;17(6):1022-1032.
  25. Choi H., Kim H.J., Bae J.H., Kim J.H., Moon du G., Cheon J., Yeo J.K. A Meta-Analysis of Long- Versus Short-Acting Phosphodiesterase 5 Inhibitors: Comparing Combination Use With a-Blockers and a-Blocker Monotherapy for Lower Urinary Tract Symptoms and Erectile Dysfunction. Int Neurourol J. 2015;19(4):237-245.
  26. Yan H., Zong H., Cui Y., Li N., Zhang Y. The efficacy of PDE5 inhibitors alone or in combination with alpha-blockers for the treatment of erectile dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and meta-analysis. J Sex Med. 2014;11(6):1539-1545.
  27. Haddad A., Jabbour M., Bulbul M. Phosphodiesterase type 5 inhibitors for treating erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia: A comprehensive review. Arab J Urol. 2015;13(3):155-161.
  28. Gacci M., Corona G., Salvi M., Vignozzi L., McVary K.T., Kaplan S.A., Roehrborn C.G., Serni S., Mirone V., Carini M., Maggi M. 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(5):994-1003.
  29. Park H.J., Won J.E., Sorsaburu S., Rivera P.D., Lee S.W. 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(3): 193-207.
  30. Umul M., Serel T.A. The role of phosphodiesterase type-5 inhibitors in treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia. Turk J Urol. 2013;39(4):264-269.
  31. Casabé A., Roehrborn C.G., Da Pozzo L.F., Zepeda S., Henderson R.J., Sorsaburu S., Henneges C., Wong D.G., Viktrup L. Efficacy and safety of the coadministration of tadalafil once daily with finasteride for 6 months in men with lower urinary tract symptoms and prostatic enlargement secondary to benign prostatic hyperplasia. J Urol. 2014;191(3):727-733.
  32. Park H.J., Park N.C. Combination therapy with dutasteride and tadalafil in men with moderate-to-severe benign prostatic hyperplasia. Eur Urol Suppl. 2013;12;e1092.
  33. Volkov A.A., Petrichko M.I., Budnik N.V., Dukhin A.R. Tadalafil in patients with benign prostatic hyperplasia during conservative combined therapy. Urologiia. 2013;2:56-59.
  34. Volkov A.A., Petrichko M.I., Budnik N.V. Correction of erectile dysfunction in patients with BPH using daily administration of tadalafil 5 mg against the background of combined drug therapy. Urologiia. 2013;5:50-54
  35. Volkov A.A., Petrichko M.I., Budnik N.V. Daily intake of phosphodiesterase type 5 inhibitors - correction of erectile dysfunction and lower urinary tract symptoms in patients with BPH. Urologiia. 2014;4:64-68

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