Phosphodiesterase type-5 inhibitors are safe and effective, alone or in combination with alpha-blockers, against lower urinary tract symptoms secondary to BPH, according to a recent systematic review and meta-analysis.
Moreover, the two-drug combination improves maximum flow rate compared to alpha-blockers alone. Younger men with lower body mass index and severe LUTS are the best candidates for PDE-5 inhibitor treatment, the review showed.
First author Mauro Gacci, MD, medical director of the University of Florence Careggi Hospital in Florence, Italy, and co-authors from Europe and the U.S. identified 508 studies in an electronic search, retrieving 106 for more detailed evaluation and finally including 12 for this review. In seven studies, patients with LUTS/BPH were treated with PDE-5 inhibitors alone: sildenafil citrate (Viagra, one study), tadalafil (Cialis, four studies), vardenafil (Levitra, Staxyn, one study), and UK-369003, an investigational agent (one study). The other five examined the effects of PDE-5 inhibitors with an alpha-blocker, using the PDE-5 inhibitors sildenafil (two studies), tadalafil (two studies), and vardenafil (one study).