Effets des inhibiteurs de la phosphodiestérase de type 5 sur les symptômes du bas appareil urinaire associés à une hypertrophie bénigne de la prostate

Abstract

The objective of this literature review was to report currently available clinical data on the effects of phosphodiesterase type 5 inhibitors (PDE5I) on lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). An international literature review was carried out in February 2012 from the Medline database (National Library of Medicine, United States). Studies on the effects of PDE5I on LUTS secondary to BPH published within the last 15 years (1997 to 2012) were extracted. In total, 12 studies were selected: four studies on sildenafil including one randomized, controlled, double-blind study; one randomized, controlled, double-blind study on vardenafil; and seven studies on tadalafil including five randomized, controlled, double-blind studies and a 1-year open-label extension study. PDE5Is significantly improve the overall international prostatic symptom score (IPSS) compared to placebo. Most often, the maximum urinary flow rate (Qmax) was not significantly increased versus placebo. A statistically significant improvement of Qmax was nevertheless observed in certain studies. The available clinical data assessing the efficacy of PDE5 inhibition in LUTS secondary to BPH are convincing. PDE5Is thus are a new therapeutic class in the treatment of this disease and are especially interesting in patients suffering from both LUTS and erectile dysfunction (ED), two frequently associated diseases.