Alpha-1 adrenergic antagonists, 5-alpha reductase inhibitors, phosphodiesterase type 5 inhibitors, and phytotherapic compounds in men with lower urinary tract symptoms suggestive of benign prostatic obstruction: A systematic review and meta-analysis of ur

2018 ◽  
Vol 37 (6) ◽  
pp. 1865-1874
Author(s):  
Ferdinando Fusco ◽  
Massimiliano Creta ◽  
Cosimo De Nunzio ◽  
Mauro Gacci ◽  
Vincenzo Li Marzi ◽  
...  
Keyword(s):  
Lower Urinary Tract ◽  
Meta Analysis ◽  
Benign Prostatic Obstruction ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Reductase Inhibitors ◽  
Urinary Tract Symptoms ◽  
Adrenergic Antagonists ◽  
Phosphodiesterase Type ◽  
5 Alpha Reductase Inhibitors ◽  
Lower Urinary

scholarly journals Defining the Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors with Tamsulosin for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Network Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Chengquan Ma ◽  
Jianzhong Zhang ◽  
Zhonglin Cai ◽  
Jian Xiong ◽  
Hongjun Li
Keyword(s):  
Erectile Dysfunction ◽  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Urinary Tract Symptoms ◽  
Phosphodiesterase Type ◽  
Lower Urinary

Purpose. The purpose of this study was to compare the relative safety and efficacy of different types of phosphodiesterase type 5 inhibitors (PDE5-Is) with tamsulosin for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) (BPH-LUTS) with or without erectile dysfunction (ED). Methods. We use the Stata version 13.0 to conduct the network meta-analysis (NMA) with a random effects model of the Bayesian framework. The International Prostate Symptom Score (IPSS), Maximum Urinary Flow Fate (Qmax), International Index of Erectile Function (IIEF), and their credible intervals (CI) were used to compare the efficacy and safety of every medical intervention, including sildenafil plus tamsulosin, tadalafil plus tamsulosin, and vardenafil plus tamsulosin. Results. Seven RCTs including 531 participants with seven interventions were analyzed. The results of NMA SUCRA showed that compared with different doses or types of PDE5-Is combined with tamsulosin (0.4 mg qd), the sildenafil (25 mg qd) combined with tamsulosin (0.4 mg qd) group had the greatest probabilities of being the best in the achievement of improving IIEF. The sildenafil (25 mg 4 days per week) combined with tamsulosin (0.4 mg qd) group had the greatest probabilities of being the best in the achievement of improving Qmax, whereas sildenafil (25 mg qd) combined with tamsulosin (0.4 mg qd) ranked the best for the safety outcomes. Conclusions. This meta-analysis indicates that sildenafil combined with tamsulosin is the best effective and tolerated treatment option for BPH-LUTS with or without ED. Further RCTs are strongly required to provide more direct evidence.

scholarly journals Sexual Dysfunctions Related to Drugs Used in the Management of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Narrative Review on α-Blockers and 5-Alpha Reductase Inhibitors

Uro ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 82-98
Author(s):  
Antonio La Torre ◽  
Caterina Palleria ◽  
Irene Tamanini ◽  
Andrea Scardigli ◽  
Tommaso Cai ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Sexual Dysfunction ◽  
Lower Urinary Tract ◽  
Prostatic Hyperplasia ◽  
Sexual Dysfunctions ◽  
Reductase Inhibitors ◽  
Urinary Tract Symptoms ◽  
5 Alpha Reductase Inhibitors ◽  
Lower Urinary

This is a critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. In this narrative review, we analyzed data from the literature related to the development of sexual dysfunctions during the treatment of BPH or LUTS. Both α-blockers and 5-alpha reductase inhibitors (5-ARIs) can induce erectile dysfunction, ejaculatory disorders and a reduction in sexual desire. The sexual side effect profile of these drugs is different. Among the α-blockers, silodosin appears to have the highest incidence of ejaculatory disorders. Persistent sexual side effects after the discontinuation of finasteride have been recently reported; however, further studies are needed to clarify the true incidence and the significance of this finding. However, most of the published studies are affected by a weak methodology and other important limitations, with only a few RCTs available. Therefore, it is desirable that future studies will include validated tools to assess and diagnose the sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders.

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