Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction

Aging Male. 2018 Dec;21(4):272-280. doi: 10.1080/13685538.2018.1432586. Epub 2018 Jan 29.

Abstract

This article summarizes years of challenging research on erectile dysfunction (ED), a condition that has an important social and cultural relevance. Preclinical and clinical research progress has led to new therapeutic approaches to ED in patients with different comorbidities and particularly in those with low urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). These goals were possible only by combined work of specialists and researchers of different and intertwined medical disciplines. Currently, tadalafil (5 mg/d) is the best choice; other phosphodiesterase-5 inhibitors (PDE5i) are not included among options, despite the growing evidence of therapeutic effects. Different regimens of tadalafil may be prescribed based on patient needs, severity of LUTS/BPH - ED profile, and clinical experience. An integrated approach is necessary to choose for a combined therapy with PDE5i and α-blockers following urological and cardiac counseling in terms of outcomes and adverse effects.

Keywords: Erectile dysfunction; LUTS; prostatic hyperplasia; treatment.

Publication types

  • Review

MeSH terms

  • Adrenergic alpha-1 Receptor Antagonists / administration & dosage
  • Adrenergic alpha-1 Receptor Antagonists / pharmacokinetics
  • Drug Therapy, Combination / methods
  • Erectile Dysfunction / drug therapy*
  • Humans
  • Lower Urinary Tract Symptoms / drug therapy*
  • Male
  • Phosphodiesterase 5 Inhibitors / administration & dosage*
  • Phosphodiesterase 5 Inhibitors / pharmacology
  • Prostatic Hyperplasia / drug therapy*
  • Tadalafil / administration & dosage
  • Tadalafil / pharmacology
  • Treatment Outcome

Substances

  • Adrenergic alpha-1 Receptor Antagonists
  • Phosphodiesterase 5 Inhibitors
  • Tadalafil