The effectiveness of sildenafil citrate in patients with erectile dysfunction and lower urinary system symptoms and the significance of asymptomatic inflammatory prostatitis

Abstract

We evaluated the effectiveness of sildenafil citrate on lower urinary system symptoms (LUTS) by using symptom score scales. We also evaluated whether or not the presence of asymptomatic inflammatory prostatitis had an effect on the alteration in the symptom scores. A total of 36 male patients were included in the study. For all the cases, 'International Prostate Symptom Score' (IPSS), 'National Health Institute Chronic Prostatitis Symptom Index' (NIH-CPSI) and 'International Index of Erectile Function' (IIEF-5) were investigated and the scores were calculated in the first visit. Sildenafil citrate was given for 30 days and at the second visit IPSS, NIH-CPSI and IIEF-5 scores were once more analyzed. Afterwards, the alterations of the scores between visits were statistically compared. Mean age of the 36 cases included in the study was 59.03 ± 1.35. When the alterations in parameters of first visit and second visit were evaluated, we found a statistically significant increase in IIEF-5 and a statistically significant decrease in IPSS, IPSS-QOL (Quality of Life). In addition, when the cases were divided into two groups with and without asymptomatic inflammatory prostatitis, in the cases with asymptomatic inflammatory prostatitis, sildenafil citrate caused improvement only in ED, but had no effect on LUTS. Sildenafil citrate use in cases with LUTS and ED has an improving effect on LUTS as well as ED. However, in cases with asymptomatic inflammatory prostatitis, sildenafil citrate did not lead to an improvement in LUTS.

Asymptomatic prostatic inflammation in men with clinical BPH and erectile dysfunction affects the positive predictive value of prostate-specific antigen

“…The data on ED and asymptomatic prostatic inflammation are not enough either. Interestingly, in a small study on men with asymptomatic chronic prostatitis, ED was more prevalent in men with evidence of inflammation [22]. Present study has also found a positive association between inflammation and ED.…”

A case‐control study on the association between chronic prostatitis/chronic pelvic pain syndrome and erectile dysfunction

“…In the present case–control study, we found that the OR for previous CP/CPPS among cases (patients with ED) was 3.62 when compared with controls, after adjusting for patient socio‐demographic characteristics, comorbidities, obesity and alcohol abuse/alcohol dependence syndrome. Previous studies have reported a high prevalences of ED, ranging from 15.0 to 48.3% in men with CP/CPPS [9,11,15,16]. Some studies also observed that CP/CPPS has a negative influence on erectile function [13,15–18], but the mechanisms underlying the association of ED with CP/CPPS remain unclear.…”

“…Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is clinically complex and aetiologically unclear, and its effects on sexual function are often overlooked [ 9,10 ] . In recent years, a number of studies have reported a high prevalence of ED among patients with CP/CPPS [ 9,11,12 ] .…”

Clinical Utility of the UPOINT Phenotype System in Chinese Males with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): A Prospective Study

“…Using penile Doppler ultrasonography, Gonen et al [28] demonstrated that none of the men with CP/CPPS and ED showed evidence of vascular deficiency that would interfere with the ability to get an erection, suggesting that psychogenic causes, mainly depression, were the main reasons for the development of ED in CP/CPPS. Several studies have suggested that ED and CP/CPPS may be linked by a shared inflammatory process originating from a prostatic source [29]–[31]. It may be possible that such prostatic inflammation affects smooth muscle relaxation and impair microvascularization of the prostate [32], thus decreasing the ability of penile tissue to fill with blood and maintain an erection [22].…”