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. 2013 Aug;5(4):211-8.
doi: 10.1177/1756287213488236.

Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction

Sidney Glina  1 , Felipe Placco Araujo Glina
Affiliations

Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction

Sidney Glina et al. Ther Adv Urol. 2013 Aug.

Abstract

Introduction: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) are clinical entities very prevalent in men aged over 50 years. There is evidence that both may have a common pathophysiology.

Objective: The objective of this study was to conduct a literature review aiming to show theories and hypotheses that justify a single pathophysiology for ED and LUTS/BPH.

Methods: A search in Medline using the keywords of the Medical Subject Headings (MESH) 'erectile dysfunction' and 'lower urinary tract symptoms' in all fields of the database up to 15 December 2012. This search found 198 relevant articles that were analyzed.

Results: The data and articles were divided according to the type of evidence found. There are strong epidemiological data showing that LUTS/BPH is a risk factor for developing ED. Several experimental models demonstrated partial obstruction of the bladder in animals causes voiding disorders as well as a negative impact on erectile function of the operated animals. The increased adrenergic tonus in animals leads to prostate growth and urodynamic conditions similar to those found in men with LUTS and ED. Arteriosclerosis may lead to loss of vesical complacency, urinary tract obstruction and fibrosis of the cavernous bodies. The use of phosphodiesterase type 5 inhibitors (PDE-5i) and/or alpha-adrenergic blockers to treat ED and LUTS/BPH reinforces the hypothesis that, at least in some patients, both clinical pictures may have the same pathophysiology.

Keywords: benign prostatic hyperplasia; erectile dysfunction; lower urinary tract symptoms.

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Conflict of interest statement

Conflict of interest statement: Sidney Glina is speaker, investigator and member of Advisory Board of Lilly Brazil; speaker and investigator for Pfizer Brazil and speaker for Bayer Healthcare Brazil. There is no conflict of interest for Felipe P. A. Glina.

References

    1. Andersson K. (2001) Pharmacology of penile erection. Pharmacol Rev 53: 417–450 - PubMed
    1. Angulo J., Cuevas P., Fernández A., La Fuente J.M., Allona A., Moncada I., Sáenz de Tejada I. (2012) Tadalafil enhances the inhibitory effects of tamsulosin on neurogenic contractions of human prostate and bladder neck. J Sexual Med 9: 2293–2306 - PubMed
    1. Bertolotto M., Trincia E., Zappetti R., Bernich R., Savoca G., Cova M.A. (2009) Effect of tadalafil on prostate haemodynamics: preliminary evaluation with contrast-enhanced US. Radiol Med 114: 1106–1114 - PubMed
    1. Bivalacqua T.J., Usta M.F., Champion H.C., Kadowitz P.J., Hellstrom W.J. (2003) Endothelial dysfunction in erectile dysfunction: Role of the endothelium in erectile physiology and disease. J Androl 24(6 Suppl.): S17–S37 - PubMed
    1. Bloch W., Klotz T., Loch C., Schmidt G., Engelmann U., Addicks K. (1997) Distribution of nitric oxide synthase implies a regulation of circulation, smooth muscle tone, and secretory function in the human prostate by nitric oxide. Prostate 33: 1–8 - PubMed

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