Does Sildenafil Affect Uroflowmetry Values in Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Enlargement?

Abstract

Aims: To investigate the effect of sildenafil on uroflowmetry values of patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic enlargement (BPE). Methods: Thirty-eight consecutive patients and 15 control subjects without voiding symptoms were enrolled in the study. All patients underwent uroflowmetry testing thrice on different occasions. The highest maximum urinary flow rate (Q_max) values with a sufficient voided volume (≧150 ml) were evaluated. The patients and controls were seen the day after the initial uroflowmetry measurements and were given 100 mg sildenafil. Afterwards uroflowmetry was repeated. The uroflowmetry values of both groups before and after sildenafil were compared. Results: Of the 38 patients, 29 (76%) showed improvement in flow rates. The mean Q_max was 11.4 ± 0.39 and 15.7 ± 0.74 ml/s before and after sildenafil, respectively (p < 0.0001). The mean percentage difference in Q_max was +38% higher after sildenafil. The mean average flow rate (Q_ave) and the mean voiding time values were also significantly improved. The mean voided volumes of the patients before and after sildenafil were 241 ± 78 and 264 ± 72 ml, respectively (p = 0.07). There were no significant differences in the Q_max, Q_ave and voided volumes of the control group. Conclusions: Sildenafil exhibits a significant improvement in Q_max and Q_ave rates in men with LUTS.

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

“…One of the interesting outcomes of our study was that when we combined patients with LUTS and without LUTS in one group, increases in Qmax and Qave values have been defined independently from age and PV. Qmax and Qave increases were not related to micturition and PVR, so that these findings were compliant with the findings from both Guven et al (2009) and Güler et al (2008).…”

“…In our study, significant increase in Qmax and Qave values in LUTS patients have been observed. However, differently from the study of Güler et al (2008), significant increases in Qmax and Qave values were observed in individuals without LUTS who were in age groups similar to those of LUTS patients (Güler et al, 2008).…”

“…In the study of Güler et al (2008), uroflowmetry was performed in 38 LUTS patients and 15 healthy controls 30 minutes after 100 mg of sildenafil intake, and increases in the flow rate were determined in 76% of LUTS patients. Moreover, after sildenafil intake the mean Qmax value was increased from 11.4 mL/s to 15.7 mL/s.…”

Phosphodiesterase (PDE) inhibitors in the treatment of lower urinary tract dysfunction

“…A single dose of the PDE5 inhibitor (50 mg or 100 mg) resulted in an improvement in Q max in the patients. Q ave and the mean voided volumes of the patients also increased while no significant differences were registered in Q max , Q ave and voided volumes of the control group before and after placebo administration [32, 33]. It should be taken into consideration that the study design, and especially the small number of patients, made it rather difficult to draw firm conclusions from these observations.…”

The recent phosphodiesterase type 5 inhibitors

“…Q ave and the mean voided volumes of the patients also increased. In the placebo group, no significant differences in Q max , Q ave and voided volumes were registered [59,60]. It should be taken into consideration that no firm conclusions from these measurements should be drawn because of the study design and the small number of patients.…”