To review the current literature regarding the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), and the role of phosphodiesterase-5 (PDE5) inhibitors for the treatment of LUTS. Review of recently published (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009) Keywords: erectile dysfunction; benign prostatic hyperplasia; lower urinary tract symptoms; LUTS; ED
IntroductionLower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are highly prevalent in aging males, with a substantial impact on quality of life (QOL). Multiple studies have shown a strong association between these two entities, independent of other risk factors. This relationship may be explained by four interrelated theories: the nitric oxide/cyclic guanosine monophosphate pathway (NO/cGMP), the Rho-kinase pathway, autonomic hyperactivity (AH), and pelvic atherosclerosis. Clinical trials have shown that phosphodiesterase-5 (PDE5)-inhibitor treatment results in significant improvement in LUTS. The exact mechanism of action is not well understood. The results of these studies indicate that PDE5-inhibitor treatment has a role in treating LUTS in the setting of ED. Furthermore, PDE5-inhibitor therapy may expand to treat not only men with ED and/or LUTS, but also LUTS in women.