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PDE5 inhibitors for LUTS

Prostate Cancer and Prostatic Diseases volume 12, pages 316–324 (2009)Cite this article

Abstract

To review the current literature regarding the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), and the role of phosphodiesterase-5 (PDE5) inhibitors for the treatment of LUTS. Review of recently published (1990–2009) data regarding epidemiologic and pathophysiologic mechanisms are involved in LUTS–ED, focusing on PDE5 inhibitors particularly evidenced from level 1 clinical trials. Search terms included phosphodiesterase inhibitors, nitric oxide, autonomic hyperactivity, Rho-kinase, atherosclerosis, LUTS, benign prostatic hypertrophy, and ED. Results of several epidemiologic studies show a possible causal relationship between LUTS and ED. Four possible mechanisms have been proposed to explain this association. Multiple large clinical trials have shown a benefit in LUTS after PDE5-inhibitors treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment.

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References

  1. Chapple CR, Roehrborn CG . A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol 2006; 49: 651–659.

    Article  PubMed  Google Scholar 

  2. Untergasser G, Madersbacher S, Berger P . Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol 2005; 40: 121–128.

    Article  PubMed  Google Scholar 

  3. McVary KT . BPH: epidemiology and comorbidities. Am J Manag Care 2006; 12: S122–S128.

    PubMed  Google Scholar 

  4. Guess HA, Arrighi HM, Metter EJ, Fozard JL . Cumulative prevalence of prostatism matches the autopsy prevalence of benign prostatic hyperplasia. Prostate 1990; 17: 241–246.

    Article  CAS  PubMed  Google Scholar 

  5. Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ et al. The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol 1993; 150: 85–89.

    Article  CAS  PubMed  Google Scholar 

  6. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  PubMed  Google Scholar 

  7. Girman CJ, Jacobsen SJ, Tsukamoto T, Richard F, Garraway WM, Sagnier PP et al. Health-related quality of life associated with lower urinary tract symptoms in four countries. Urology 1998; 51: 428–436.

    Article  CAS  PubMed  Google Scholar 

  8. Guest JF, Das Gupta R . Health-related quality of life in a UK-health-related quality of life in a UK-based population of men with erectile dysfunction. Pharmacoeconomics 2002; 20: 109–117.

    Article  PubMed  Google Scholar 

  9. Calais Da Silva F, Marquis P, Deschaseaux P, Gineste JL, Cauquil J, Patrick DL . Relative importance of sexuality and quality of life in patients with prostatic symptoms. Results of an international study. Eur Urol 1997; 31: 272–280.

    Article  CAS  PubMed  Google Scholar 

  10. Kirby RS . The natural history of benign prostatic hyper-plasia: what have we learned in the last decade? Urology 2000; 56: 3–6.

    Article  CAS  PubMed  Google Scholar 

  11. Lukacs B, Leplège A, Thibault P, Jardin A . Prospective study of men with clinical benign prostatic hyperplasia treated with alfuzosin by general practitioners: 1-year results. Urology 1996; 48: 731–740.

    Article  CAS  PubMed  Google Scholar 

  12. Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I, Rodriguez-Vela L, Jimenez-Cruz JF, Burgos-Rodriguez R . Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study. J Urol 2001; 166: 569–575.

    Article  CAS  PubMed  Google Scholar 

  13. Braun MH, Sommer F, Haupt G, Mathers MJ, Reifenrath B, Engelmann UH . Lower urinary tract symptoms and erectile dysfunction: co-morbidity or typical ‘aging male’ symptoms? Results of the ‘Cologne Male Survey’. Eur Urol 2003; 44: 588–594.

    Article  CAS  PubMed  Google Scholar 

  14. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; 44: 637–649.

    Article  PubMed  Google Scholar 

  15. Andersson KE . Erectile physiological and pathophysiological pathways involved in erectile dysfunction. J Urol 2003; 170: S6–14.

    Article  PubMed  Google Scholar 

  16. Carvajal JA, Germain AM, Huidobro-Toro JP, Weiner CP . Molecular mechanism of cGMP-mediated smooth muscle relaxation. J Cell Physiol 2000; 184: 409–420.

    Article  CAS  PubMed  Google Scholar 

  17. Kohler TS, McVary KT . The relationship between erectile dysfunction and lower urinary tract symptoms and the role of phosphodiesterase type 5 inhibitors. Eur Urol 2009; 55: 38–48.

    Article  CAS  PubMed  Google Scholar 

  18. Andersson KE, Persson K . Nitric oxide synthase and the lower urinary tract: possible implications for physiology and pathophysiology. Scand J Urol Nephrol 1995; 175 (Suppl): 43–53.

    CAS  Google Scholar 

  19. Hedlund P . Nitric oxide/cGMP-mediated eVects in the out-Xow region of the lower urinary tract—is there a basis for pharmacological targeting of cGMP? World J Urol 2005; 23: 362–367.

    Article  CAS  PubMed  Google Scholar 

  20. Andersson KE . LUTS treatment: future treatment options. Neurourol Urodyn 2007; 26: 928–933.

    Article  CAS  PubMed  Google Scholar 

  21. Burnett AL, Maguire MP, Chamness SL, Ricker DD, Takeda M, Lepor H et al. Characterization and localization of nitric oxide synthase in the human prostate. Urology 1995; 45: 435–439.

    Article  CAS  PubMed  Google Scholar 

  22. Richter K, Heuer O, ckert S, Stief CG, Jonas U, Wolf G . Immunocytochemical distribution of nitric oxide synthases in the human prostate. J Urol 2004; 171 (Suppl 4): 347 (abstract).

    Article  Google Scholar 

  23. Bloch W, Klotz T, Loch C, Schmidt G, Engelmann U, Addicks K . Distribution of nitric oxide synthase implies a regulation of circulation, smooth muscle tone, and secretory function in the human prostate by nitric oxide. Prostate 1997; 33: 1–8.

    Article  CAS  PubMed  Google Scholar 

  24. Gradini R, Realacci M, Ginepri A, Naso G, Santangelo C, Cela O et al. Nitric oxide synthases in normal and benign hyperplastic human prostate: immunohistochemistry and molecular biology. J Pathol 1999; 189: 224–229.

    Article  CAS  PubMed  Google Scholar 

  25. Luo J, Dunn T, Ewing C, Sauvageot J, Chen Y, Trent J et al. Gene expression signature of benign prostatic hyperplasia revealed by cDNA microarray analysis. Prostate 2002; 51: 189–200.

    Article  CAS  PubMed  Google Scholar 

  26. Uckert S, Oelke M, Stief CG, Andersson KE, Jonas U, Hedlund P . Immunohistochemical distribution of cAMP- and cGMP-phosphodiesterase (PDE) isoenzymes in the human prostate. Eur Urol 2006; 49: 740–745.

    Article  CAS  PubMed  Google Scholar 

  27. Morley DJ, Hawley DM, Ulbright TM, Butler LG, Culp JS, Hodes ME . Distribution of phosphodiesterase in normal human tissues. J Histochem Cytochem 1987; 35: 75–82.

    Article  CAS  PubMed  Google Scholar 

  28. Truss MC, Stief CG, Uckert S, Becker AJ, Wefer J, Schultheiss D et al. Phosphodiesterase 1 inhibition in the treatment of lower urinary tract dysfunction: from bench to bedside. World J Urol 2001; 19: 344–350.

    Article  CAS  PubMed  Google Scholar 

  29. Longhurst PA, Briscoe JA, Rosenberg DJ, Leggett RE . The role of cyclic nucleotides in guinea-pig bladder contractility. Br J Pharmacol 1997; 121: 1665–1672.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Snyder PB, Loughney K, Florio VA . Relaxation of bladder strips by inhibition of cyclic nucleotide phosphodiesterase type 4 (PDE4) (abstract 159). J Urol 2005; 173: 43.

    Article  Google Scholar 

  31. Gillespie JI . Phosphodiesterase-linked inhibition of nonmicturition activity in the isolated bladder. BJU Int 2004; 93: 1325–1332.

    Article  CAS  PubMed  Google Scholar 

  32. Werkstrom V, Svensson A, Andersson K-E, Hedlund P . Phosphodiesterase 5 in the female pig and human urethra: morphological and functional aspects. BJU Int 2006; 98: 414–423.

    Article  CAS  PubMed  Google Scholar 

  33. Oger S, Behr-Roussel D, Lecoz O, Lebret T, Denoux Y, Bernabé J et al. Evaluation of relaxant effects of the combination of sildenafil and doxazosin in human prostate. Eur Urol Suppl 2007; 6: 33.

    Article  Google Scholar 

  34. McVary KT, Roehrborn CG, Kaminetsky JC, Auerbach SM, Wachs B, Young JM et al. Tadalafil relieves lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 2007; 177: 1401–1407.

    Article  CAS  PubMed  Google Scholar 

  35. Takeda M, Tang R, Shapiro E, Burnett AL, Lepor H . Effects of nitric oxide on human and canine prostates. Urology 1995; 45: 440–446.

    Article  CAS  PubMed  Google Scholar 

  36. Kedia G, ckert S, Scheller F, Chigogidze T, Managadze L, Jonas U et al. In vitro functional responses of isolated normal human prostatic tissue to compounds interacting with the cyclic guanosine monophosphate pathway. Urology 2006; 67: 1292–1297.

    Article  PubMed  Google Scholar 

  37. Kedia G, ckert S, Kedia M, Truss MC, Chigogidze T, Jonas U et al. In vitro effects of drugs interfering with the cAMP- and cGMP-pathway on the tension induced by endothelin-1 of isolated human prostate tissue. Georgian Med News 2006; 131: 7–13.

    Google Scholar 

  38. Guh JH, Hwang TL, Ko FN, Chueh SC, Lai MK, Teng CM . Antiproliferative effect in human prostatic smooth muscle cells by nitric oxide donor. Mol Pharmacol 1998; 53: 467–474.

    Article  CAS  PubMed  Google Scholar 

  39. Ückert S, Sormes M, Kedia G, Gratzke C, Stief CG, Scheller F et al. Effects of PDE inhibitors on the tension induced by norepinephrine and accumulation of cyclic nucleotides in isolated human prostate tissue. Urology 2006; 45 (Suppl 1): 25–26 (abstract).

    Google Scholar 

  40. Kedia G, Sormes M, ckert S, Scheller F, Jonas U . Contraction-relaxation studies on isolated human prostate tissue: the role of endothelin 1, phosphodiesterase inhibitors and cyclic nucleotides. Eur Urol 2007; 6 (Suppl 2): 34 (abstract).

    Article  Google Scholar 

  41. Snyder PB, Loughney K, Florio VA . Relaxation of bladder strips by inhibition of cyclic nucleotide phosphodiesterase type 4 (PDE4) (abstract 159). J Urol 2005; 173: 43.

    Article  Google Scholar 

  42. Gillespie JI, Markerink-van Ittersum M, de Vente J . cGMP-generating cells in the bladder wall: identification of distinct networks of interstitial cells. BJU Int 2004; 94: 1114–1124.

    Article  PubMed  Google Scholar 

  43. Gillespie JI, Markerink-van Ittersum M, de Vente J . Expression of neuronal nitric oxide synthase (nNOS) and nitric-oxide-induced changes in cGMP in the urothelial layer of the guinea pig bladder. Cell Tissue Res 2005; 321: 341–351.

    Article  CAS  PubMed  Google Scholar 

  44. Gillespie JI, Markerink-van Ittersum M, De Vente J . Endogenous nitric oxide/cGMP signalling in the guinea pig bladder: evidence for distinct populations of sub-urothelial interstitial cells. Cell Tissue Res 2006; 325: 325–332, 1489–1495.

    Article  CAS  PubMed  Google Scholar 

  45. Eckel RH, Grundy SM, Zimmet PZ . The metabolic syndrome. Lancet 2005; 365: 1415–1428.

    Article  CAS  PubMed  Google Scholar 

  46. Hammarsten J, Hogstedt B, Holthuis N, Mellstrom D . Components of the metabolic syndrome-risk factors for the development of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 1998; 1: 157–162.

    Article  CAS  PubMed  Google Scholar 

  47. Hammarsten J, Hogstedt B . Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia. Blood Press 1999; 8: 29–36.

    Article  CAS  PubMed  Google Scholar 

  48. Meigs JB, Mohr B, Barry MJ, Collins MM, McKinlay JB . Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol 2001; 54: 935–944.

    Article  CAS  PubMed  Google Scholar 

  49. McVary KT, Razzaq A, Lee C, Venegas MF, Rademaker A, McKenna KE . Growth of the rat prostate gland is facilitated by the autonomic nervous system. Biol Reprod 1994; 51: 99–107.

    Article  CAS  PubMed  Google Scholar 

  50. Golomb E, Rosenzweig N, Eilam R, Abramovici A . Spontaneous hyperplasia of the ventral lobe of the prostate in aging genetically hypertensive rats. J Androl 2000; 21: 58–64.

    CAS  PubMed  Google Scholar 

  51. Rahman NU, Phonsombat S, Bochinski D, Carrion RE, Nunes L, Lue TF . An animal model to study lower urinary tract symptoms and erectile dysfunction: the hyperlipidemic rat. BJU Int 2007; 100: 658–663.

    Article  PubMed  Google Scholar 

  52. Persson K, Pandita RK, Spitsbergen JM, Steers WD, Tuttle JB, Andersson KE . Spinal and peripheral mechanisms contributing to hyperactive voiding in spontaneously hypertensive rats. Am J Physiol 1998; 275: 1366–1373.

    Google Scholar 

  53. Hale TM, Okabe H, Bushfield TL, Heaton JP, Adams MA . Recovery of erectile function after brief aggressive anti-hypertensive therapy. J Urol 2002; 168: 348–354.

    Article  CAS  PubMed  Google Scholar 

  54. McVary KT, Rademaker A, Lloyd GL, Gann P . Autonomic nervous system overactivity in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 2005; 174: 1327–1433.

    Article  PubMed  Google Scholar 

  55. Holmquist F, Andersson KE, Hedlund H . Actions of endothelin on isolated corpus cavernosum from rabbit and man. Acta Physiol Scand 1990; 139: 113–122.

    Article  CAS  PubMed  Google Scholar 

  56. Azadzoi KM, Kim N, Brown ML, Goldstein I, Cohen RA, Saenz de Tejada I . Endothelium-derived nitric oxide and cyclooxygenase products modulate corpus cavernosum smooth muscle tone. J Urol 1992; 147: 220–225.

    Article  CAS  PubMed  Google Scholar 

  57. Uckert S, Sormes M, Kedia G, Scheller F, Knapp WH, Jonas U et al. Effects of phosphodiesterase inhibitors on tension induced by norepinephrine and accumulation of cyclic nucleotides in isolated human prostatic tissue. Urology 2008; 71: 526–530.

    Article  PubMed  Google Scholar 

  58. Ahn GJ, Yu JY, Choi SM, Kang KK, Ahn BO, Kwon JW et al. Chronic administration of phosphodiesterase 5 inhibitor improves erectile and endothelial function in a rat model of diabetes. Int J Androl 2005; 28: 260–266.

    Article  CAS  PubMed  Google Scholar 

  59. Rees RW, Ziessen T, Ralph DJ, Kell P, Moncada S, Cellek S . Human and rabbit cavernosal smooth muscle cells express Rho-kinase. Int J Impot Res 2002; 14: 1–7.

    Article  CAS  PubMed  Google Scholar 

  60. Somlyo AP, Somlyo AV . Signal transduction by G-proteins, Rho-kinase and protein phosphatase to smooth muscle and non smooth muscle myosin II. J Physiol 2000; 522: 177–185.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Rees RW, Foxwell NA, Ralph DJ, Kell PD, Moncada S, Cellek S . Y-27632, a Rho-kinase inhibitor, inhibits proliferation and adrenergic contraction of prostatic smooth muscle cells. J Urol 2003; 170: 2517–2522.

    Article  CAS  PubMed  Google Scholar 

  62. Lindberg C, Nishtman D, Malmqvist UP, Abrahamsson PA, Andersson KE, Hedlund P et al. Increased expression of RhoA in prostates of spontaneously hypertensive rats. J Urol 2004; 171 (Suppl): 348, A1320.

    Article  Google Scholar 

  63. Bing W, Chang S, Hypolite JA, DiSanto ME, Zderic SA, Rolf L et al. Obstruction-induced changes in urinary bladder smooth muscle contractility: a role for Rho kinase. Am J Physiol Renal Physiol 2003; 285: F990–F997.

    Article  PubMed  Google Scholar 

  64. Chang S, Hypolite JA, Zderic SA, Wein AJ, Chacko S, DiSanto ME . Increased corpus cavernosum smooth muscle tone associated with partial bladder outlet obstruction is mediated via Rho-kinase. Am J Physiol Regul Integr Comp Physiol 2005; 289: R1124–R1130.

    Article  CAS  PubMed  Google Scholar 

  65. Chang S, Hypolite JA, Changolkar A, Wein AJ, Chacko S, DiSanto ME . Increased contractility of diabetic rabbit corpora smooth muscle in response to endothelin is mediated via Rho-kinase beta. Int J Impot Res 2003; 15: 53–62.

    Article  CAS  PubMed  Google Scholar 

  66. Seko T, Ito M, Kureishi Y, Okamoto R, Moriki N, Onishi K et al. Activation of RhoA and inhibition of myosin phosphatase as important components in hypertension in vascular smooth muscle. Circ Res 2003; 92: 411–418.

    Article  CAS  PubMed  Google Scholar 

  67. Rajasekaran M, White S, Baquir A, Wilkes N . Rho-kinase inhibition improves erectile function in aging male Brown-Norway rats. J Androl 2005; 26: 182–188.

    Article  CAS  PubMed  Google Scholar 

  68. Tarcan T, Azadzoi KM, Siroky MB, Goldstein I, Krane RJ . Age related erectile and voiding dysfunction: the role of arterial insufficiency. Brit J Urol 1998; 82: 26–33.

    Article  PubMed  Google Scholar 

  69. Ponholzer A, Temml C, Wehrberger C, Marszalek M, Maderbacher S . The association between LUTS and vascular risk factors in both sexes. Eur Urol 2006; 50: 581–586.

    Article  PubMed  Google Scholar 

  70. Azadzoi KM, Tarcan T, Siroky MB, Krane RJ . Atherosclerosis-induced chronic ischemia causes bladder fibrosis and noncompliance in the rabbit. J Urol 1999; 161: 1626–1635.

    Article  CAS  PubMed  Google Scholar 

  71. Kozlowski R, Kershen RT, Siroky MB, Krane RJ, Azadzoi KM . Chronic ischemia alters prostate structure and reactivity in rabbits. J Urol 2001; 165: 1019–1026.

    Article  CAS  PubMed  Google Scholar 

  72. Azadzoi KM, Babayan RK, Kozlowski R, Siroky MB . Chronic ischemia increases prostatic smooth muscle contraction in the rabbit. J Urol 2003; 170: 659–663.

    Article  PubMed  Google Scholar 

  73. McVary K . Erectile dysfunction and lower urinary tract symptoms secondary to BPH. Eur Urol 2005; 47: 838–845.

    Article  PubMed  Google Scholar 

  74. Sairam K, Kulinskaya E, McNicholas TA, Boustead GB, Hanbury DC . Sildenafil influences lower urinary tract symptoms. BJU Int 2002; 90: 836–839.

    Article  CAS  PubMed  Google Scholar 

  75. Mulhall JP, Guhring P, Parker M, Hopps C . Assessment of the impact of sildenafil citrate on lower urinary tract symptoms in men with erectile dysfunction. J Sex Med 2006; 3: 662–667.

    Article  CAS  PubMed  Google Scholar 

  76. Ying J, Yao D, Jiang Y, Ren X, Xu M . The positive effect of sildenafil on LUTS from BPH while treating ED. Zhonghua Nan Ke Xue 2004; 10: 681–683.

    PubMed  Google Scholar 

  77. Kaplan SA, Gonzalez RR, Te AE . Combination of alfuzosin and sildenafil is superior to monotherapy in treating lower urinary tract symptoms and erectile dysfunction. Eur Urol 2007; 51: 1717–1723.

    Article  CAS  PubMed  Google Scholar 

  78. McVary KT, Monnig W, Camps JL, Young JM, Tseng LJ, van den Ende G . Sildenafil citrate improves erectile function andprostatic hyperplasia, low- and high-grade prostatic intraepithelial neoplasia and prostatic carcinoma. BJU Int 2007; 88: 100–103.

    Google Scholar 

  79. Stief CG, Porst H, Neuser D, Beneke M, Ulbrich E . A randomized, 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.

    Article  CAS  PubMed  Google Scholar 

  80. Roehrborn CG, McVary KT, Elion-Mboussa A, Viktrup L . Tadalafil administered once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a dose finding study. J Urol 2008; 180: 1228–1234.

    Article  CAS  PubMed  Google Scholar 

  81. Roehrborn RC . Efficacy and safety of once-daily alfuzosin in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a randomized, placebo controlled trial. Urology 2001; 58: 953–959.

    Article  CAS  PubMed  Google Scholar 

  82. Gacci M, Del Populo G, Macchiarella A, Celso M, Vittori G, Lapini A et al. Vardenafil improves urodynamic parameters in men with spinal cord injury: results from a single dose, pilot study. J Urol 2007; 178: 2040–2043.

    Article  CAS  PubMed  Google Scholar 

  83. Filippi S, Morelli A, Sandner P, Fibbi B, Mancina R, Marini M et al. Characterization and functional role of androgen-dependent PDE5 activity in the bladder. Endocrinology 2007; 148: 1019–1029.

    Article  CAS  PubMed  Google Scholar 

  84. Yono M, Yamamoto Y, Yoshida M, Ueda S, Latifpour J . Effects of doxazosin on blood Xow and mRNA expression of nitric oxide synthase in the spontaneously hypertensive rat genitourinary tract. Life Sci 2007; 81: 218–222.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Pinggera GM, Schuster A, Frauscher F, Bartsch G, Strasser H . Sildenafil citrate causes a 3-fold increase in periurethral prostatic blood Xow. J Urol 2004; 171 (Suppl 4): 355 (abstract).

    Article  Google Scholar 

  86. Guh JH, Hwang TL, Ko FN, Chueh SC, Lai MK, Teng CM . Antiproliferative effect in human prostatic smooth muscle cells by nitric oxide donor. Mol Pharmacol 1998; 53: 467–547.

    Article  CAS  PubMed  Google Scholar 

  87. Adolfsson PI, Ahlstrand C, Varenhorst E, Svensson SP . Lysophosphatidic acid stimulates proliferation of cultured muscle cells from human BPH tissue: sildenafil and papaverine generate inhibition. Prostate 2002; 51: 50–58.

    Article  CAS  PubMed  Google Scholar 

  88. Deng CH, Chen HR, Qiu SP, Liu JZ, Zheng KL, Mei H . Effect of nitric oxide donor and alpha1-receptor antagonist on proliferation/apoptosis of hyperplastic prostatic stromal cells in vitro. Zhonghua Wai Ke Za Zhi 2004; 42: 201–204.

    PubMed  Google Scholar 

  89. Uckert S, Kuthe A, Jonas U, Stief CG . Characterization and functional relevance of cyclic nucleotide phosphodiesterase isoenzymes of the human prostate. J Urol 2001; 166: 2484.

    Article  CAS  PubMed  Google Scholar 

  90. Dmochowski R, Roehrborn C, Kraus S, Klise S . Changes in bladder outlet obstruction index in men with signs and symptoms of benign prostatic hyperplasia treated with tadalafil. J Urol 2009; (suppl): 181: (abstract 1924).

    Article  Google Scholar 

  91. Moreira Jr ED, Lbo CF, Diament A, Nicolosi A, Glasser DB . Incidence of erectile dysfunction in men 40 to 69 years old: results from a population-based cohort study in Brazil. Urology 2003; 61: 431–436.

    Article  PubMed  Google Scholar 

  92. Shiri R, Hakkinen JT, Hakama M, Huhtala H, Auvinen A, Tammela TL et al. Effect of lower urinary tract symptoms on the incidence of erectile dysfunction. J Urol 2005; 174: 205–209.

    Article  PubMed  Google Scholar 

  93. Chai TC, Belville WD, McGuire EJ, Nyquist L . Specificity of the American Urological Association Voiding Symptom Index: comparison of unselected and selected samples of both sexes. J Urol 1993; 150: 1710–1713.

    Article  CAS  PubMed  Google Scholar 

  94. Tinel H, Stelte-Ludwig B, Hütter J, Sandner P . Pre-clinical evidence for the use of phosphodiesterase-5 inhibitors for treating benign prostatic hyperplasia and lower urinary tract symptoms. BJU Int 2006; 98: 1259–1263.

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

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Mouli, S., McVary, K. PDE5 inhibitors for LUTS. Prostate Cancer Prostatic Dis 12, 316–324 (2009). https://doi.org/10.1038/pcan.2009.27

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