Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH-LUTS

Selim Cellek, Norman E Cameron, Mary A Cotter, Christopher H Fry, Dapo Ilo

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) and erectile dysfunction commonly coexist, and both respond to phosphodiesterase (PDE) 5 inhibitors, suggesting a shared pathophysiological mechanism. We propose that both BPH-LUTS and erectile dysfunction are caused by microvascular dysfunction within the pelvic organs, and we present an overview of preclinical and clinical studies supporting the hypothesis that, within both the penis and the lower urinary tract, a combination of endothelial and neural dysfunction leads to a vicious cycle of hypoxia, vasoconstriction, altered smooth muscle contractility, and degeneration of autonomic neurons and ganglia. This hypothesis explains much of the preclinical and clinical research relating to these two conditions, and provides a rationale for further investigation into the effects of PDE5 inhibitors on the pathophysiology and symptoms of BPH-LUTS.

Original languageEnglish
Pages (from-to)231-241
Number of pages11
JournalNature reviews. Urology
Volume11
Issue number4
Early online date11 Mar 2014
DOIs
Publication statusPublished - Apr 2014

Fingerprint

Phosphodiesterase 5 Inhibitors
Lower Urinary Tract Symptoms
Prostatic Hyperplasia
Erectile Dysfunction
Autonomic Ganglia
Nerve Degeneration
Penis
Vasoconstriction
Urinary Tract
Smooth Muscle
Research

Keywords

  • Erectile Dysfunction
  • Humans
  • Lower Urinary Tract Symptoms
  • Male
  • Microvessels
  • Phosphodiesterase 5 Inhibitors
  • Prostatic Hyperplasia
  • Vascular Diseases

Cite this

Cellek, S., Cameron, N. E., Cotter, M. A., Fry, C. H., & Ilo, D. (2014). Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH-LUTS. Nature reviews. Urology, 11(4), 231-241. https://doi.org/10.1038/nrurol.2014.53

Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH-LUTS. / Cellek, Selim; Cameron, Norman E; Cotter, Mary A; Fry, Christopher H; Ilo, Dapo.

In: Nature reviews. Urology, Vol. 11, No. 4, 04.2014, p. 231-241.

Research output: Contribution to journalArticle

Cellek, S, Cameron, NE, Cotter, MA, Fry, CH & Ilo, D 2014, 'Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH-LUTS', Nature reviews. Urology, vol. 11, no. 4, pp. 231-241. https://doi.org/10.1038/nrurol.2014.53
Cellek, Selim ; Cameron, Norman E ; Cotter, Mary A ; Fry, Christopher H ; Ilo, Dapo. / Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH-LUTS. In: Nature reviews. Urology. 2014 ; Vol. 11, No. 4. pp. 231-241.
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