Current Urology Reports

, Volume 14, Issue 6, pp 585–594 | Cite as

The use of PDE-5 Inhibitors in the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

  • Casey Lythgoe
  • Kevin T. McVaryEmail author
Benign Prostatic Hyperplasia (K McVary and S Kaplan, Section Editors)


The relationship between lower urinary tract symptoms secondary to BPH and ED has recently been the subject of significant research due to the prevalence of both conditions concomitantly existing in older men. Many large-scale studies have demonstrated an association between erectile dysfunction and lower urinary tract symptoms. Although the mechanisms underlying the relationship between LUTS and ED are not fully elucidated, several theories are currently proposed in literature: the nitric oxide/cGMP pathway, RhoA/Rho-kinase signaling, pelvic atherosclerosis associated with chronic hypoxia, and autonomic adrenergic hyperactivity. The mechanisms by which these pathways affect the bladder, prostate, pelvic vasculature and spinal cord are also the subject of current research. In this chapter, we examine the randomized, placebo-controlled trials that have evaluated the use of PDE-5Is in LUTS, as well as randomized, controlled trials (RCTs) researching combination PDE-5Is and alpha blockers.


PDE-5 INHIBITORS Benign Prostatic Hyperplasia AUA Symptom Index (AUA-SI) Lower Urinary Tract Symptoms (LUTS) 


Compliance with Ethics Guidelines

Conflict of Interest

Dr. Casey Lythgoe reported no potential conflicts of interest relevant to this article.

Dr. Kevin McVary received consultancies and honoraria from Allergan, Lilly/ICOS, NxThera, and Watson Pharmaceuticals. Dr. McVary received honoraria and payment for the development of educational presentations including service on speakers’ bureaus from GSK.

Dr. McVary serves as a Section Editor for Current Urology Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of outstanding importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of UrologySouthern Illinois University School of MedicineSpringfieldUSA

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