Acute Effects of Sildenafil on Uroflowmetric Parameters in Erectile Dysfunction Patients With and Without Lower Urinary Tract Symptoms

Abstract

Using phosphodiesterase type 5 (PDE5) inhibitors in patients with lower urinary tract symptoms continues to draw attention. Despite clinical improvements in patients, it is still debatable whether urinary flow rates are increased or not. The aim of this study was to evaluate the acute effects of sildenafil, a PDE5 inhibitor, on uroflowmetry parameters. A total of 110 men who had applied to our outpatient clinics and who had had no history of alpha blocker and PDE5 inhibitor use were included in our study. Two uroflowmetries were performed within 24-72 hours without any treatment. Participants received 50 mg of sildenafil at their third visit, and uroflowmetry was repeated after 2 hours. A total of 102 men were included in the analysis, and baseline uroflowmetry values were compared with values obtained after sildenafil use. The mean age of the 102 participants who had attended all three visits (92.7%) was 52.1 6 12.2 years. Mean of baseline maximal flow rate values were 17.1 6 5.1 mL/s, mean of baseline maximal flow rate after sildenafil was 18.2 6 5.1 mL/s; average flow rate values at the baseline and after sildenafil were 9.5 6 3.5 and 9.9 6 3.5 mL/s, respectively. Means of postvoid residual urine volume for baseline and after sildenafil were 31.2 6 20.1 and 27.7 6 18.4 mL, respectively. Statistically significant difference is determined between baseline and postsildenafil values in terms of average flow rates at baseline and postvoid residual urine values. Results of this study suggest that sildenafil has an effect on uroflowmetric parameters during an acute period.Key words: BPH, uroflowmetry, acute urinary retention. J Androl 2012;33:1165-1168 L ower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are frequently encountered problems in aging men (Feldman et al, 1994;McVary, 2006a). For a long time, these two situations have been accepted as a natural result of aging, but epidemiologic studies have revealed that both are mutual risk factors for each other, independent from other risk factors (Rosen et al, 2003). Although both situations rarely cause fatal complications, they significantly decrease quality of life.Both laboratory and clinical trials show that LUTS and ED are related, as has been confirmed with epidemiologic studies. Alpha blockers demonstrated improvement in erectile function in patients with LUTS, which is related to benign prostatic hyperplasia (BPH; Leungwattanakij et al, 2010). Similarly, there are also some studies indicating that phosphodiesterase type 5 (PDE5) inhibitors have caused improvements in symptom scores and the quality of life in patients with LUTS. Increase of maximal flow rate (Qmax) in patients treated with alpha blockers is usually associated with improvements in symptom scores. Even though some improvement is observed regarding the International Prostate Symptom Score (IPSS), no increase is found in Qmax value in nearly all of the studies using PDE5 inhibitors (McVary et al, 2007;Stief et al, 2008;Roehrborn et al, 2010). The aim of this study was to...

Tek doz tadalafil 20 mg verildikten üç saat sonra idrar akım hızını arttırmaktadır

“…[18] Başka bir çalışmada ED hastalarında sildenafilden sonraki ikinci saatte üroflovmetri değerlerine bakıldığında, AÜSS'u olsun ya da olmasın olumlu katkıda bulunduğu gösterilmiştir (Qmax (17,1±5,1 ila 18,2±5,1, p<0,001), Qave (9,5±3,5 ila 9,9±3,5, p=0,004) ve PVR (31,2±20,1 ila 27,7±18,4, p<0,001)). [19] Çalışmamızda tadalafil akut dönemde üroflovmetrik parametrelere ve PVR'ye olumlu katkıda bulunmuştur.…”

Current Diagnosis and Management of Erectile Dysfunction

“…Animal models have demonstrated that bladder neck obstruction results in increased cavernosal smooth muscle tone and worse erectile function [42, 43], and investigators have confirmed high expression of PDE5 in the genital tissues, with PDE5i's decreasing genital muscle contraction in a dose-dependent manner [44]. Clinical evidence demonstrates an improvement in International Index of Erectile Function (IIEF) and International Prostate Symptom Score (IPSS) in treated patients, with a small but significant improvement in urinary flow in men taking sildenafil [45•, 46]. …”