Uroflowmetric assessment of acute effects of sildenafil on the voiding of men with erectile dysfunction and symptomatic benign prostatic hyperplasia

Güven, Eşref Oğuz; Balbay, Mevlana Derya; Kilciler, Mete; Şerefoğlu, Ege Can

doi:10.1007/s11255-008-9423-y

Cited by 19 publications

(13 citation statements)

References 23 publications

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“…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).…”

Section: Discussionsupporting

confidence: 91%

“…Two hours after the drug intake, uroflowmetry was performed in all patients. Although there was no significant difference in Qmax and Qave values in the control group, significant increase was observed in Qmax and Qave values in sildenafil group (Guven et al, 2009). However, in this study patient groups were specific in that they had ED and LUTS concomitantly, and so it may not be correct to conclude the same outcome for patients who have only LUTS.…”

Section: Discussionmentioning

confidence: 77%

“…Haaga et al (2007) reported that sildenafil increased prostatic blood flow in the acute phase. Although Guven et al (2009) proposed that this condition might lead to prostatic congestion and related sudden micturition disorders, there still has not been enough evidence in favor of this mechanism.…”

Section: Discussionmentioning

confidence: 99%

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

Öztürk

Koca

Sertkaya

et al. 2012

Journal of Andrology

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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...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 77%

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

Öztürk

Koca

Sertkaya

et al. 2012

Journal of Andrology

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“…No significant change was seen in urinary flow rates, however. Another small‐scale RCT did see a significant improvement in urinary flow rates 148 . An RCT with three treatment arms, alfuzosin 10 mg daily, sildenafil 25 mg daily, and combination therapy, found significant improvements in IPSS and ED in the combination therapy group in comparison with the monotherapy groups 149 .…”

Section: Treatmentmentioning

confidence: 99%

JUA clinical guidelines for benign prostatic hyperplasia

et al. 2011

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Abstract:The Japanese Urological Association has developed Clinical Guidelines for Benign Prostatic Hyperplasia (BPH) for men with suspected BPH. This article is an English translation of the abridged version of the Guidelines. The Guidelines were formulated on the basis of evidence retrieved from the PubMed database between 1995 and 2009, as well as other relevant sources. The target patients of these Guidelines are men with suspected BPH, and the target users are urologists. A mandatory assessment should include a medical history, a physical examination, the completion of symptom and quality of life questionnaires, a urinalysis, a prostate ultrasonography, measurement of serum prostate specific antigen and postvoid residual urine, and uroflowmetry. Optional tests include keeping a bladder diary, the measurement of serum creatinine, and upper urinary tract ultrasonography. Care should be taken to not overlook coexisting diseases such as infections or malignancies that may obscure the diagnosis. Treatment should consist of conservative therapy or the use of medications such as a1-adrenoceptor antagonists, or both. The use of 5a-reductase inhibitors or anticholinergic agents should be considered in patients with an enlarged prostate (>30 mL) or overactive bladder symptoms (Overactive Bladder Symptom Score Ն6), respectively. Surgical intervention is indicated when non-surgical treatments fail to provide sufficient symptomatic relief, and when bladder outlet obstruction is highly suspected.

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“…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.…”

Section: Premature Ejaculationmentioning

confidence: 94%

The recent phosphodiesterase type 5 inhibitors

Ückert¹,

Becker²,

Stief³

et al. 2012

Human Andrology

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Uroflowmetric assessment of acute effects of sildenafil on the voiding of men with erectile dysfunction and symptomatic benign prostatic hyperplasia

Abstract: Despite the limitations of variations of uroflowmetry, this study showed that sildenafil improves Q (max) and Q (avg) in patients suffering from ED with concomitant BPH-LUTS. Long-term studies are needed to evaluate the effects on IPSS, side effects, and drug interactions.

Cited by 19 publications

References 23 publications

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

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

JUA clinical guidelines for benign prostatic hyperplasia

The recent phosphodiesterase type 5 inhibitors

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