PARIS—Phosphodiesterase-5 (PDE-5) inhibitors significantly improve lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) and can be considered as an alternative treatment for BPH-related LUTS in men with or without erectile dysfunction, researchers reported at the 27th Annual Congress of the European Association of Urology.
That is the conclusion of a systematic review and meta-analysis of data from 12 randomized controlled trials that included a total of 3,492 patients. Seven trials (with a total of 3,214 patients) compared PDE-5 inhibitors with placebo and five (with a total of 216 patients) comparing a combination of PDE-5 inhibitors and alpha blockers with alpha blockers alone.
Combining the results of those trials, the use of PDE-5 inhibitors alone was associated with a significant improvement in International Index of Erectile Function (IIEF) score and International Prostate Symptom Score (IPSS), but not peak flow rate at the end of the study compared with placebo. The combination of PDE-5 inhibitors and alpha blockers improved IIEF score, IPSS, and peak flow rate at the end of the study compared with alpha blockers alone.
The researchers, led by Mauro Gacci, MD, of the University of Florence in Italy, concluded that younger men with lower body mass index and severe LUTS are the best candidates for PDE-5 inhibitors.