الفهرس 
PHYSIOLOGY AND PATHOPHYSIOLOGY OF LUT
Management of Benign Prostatic HyperplasiaOnly 14 pages are availabe for public view
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Abstract
Lower urinary tract symptoms (LUTS) associated with
benign prostatic hyperplasia (BPH) are common
conditions in middle-age or older men. LUTS range from mild
to severe, and include obstructive symptoms such as hesitancy,
incomplete emptying, and weak stream, and irritative
symptoms such as frequency, urgency, and nocturia, that can
strongly worsen the quality of life (QoL). For several years,
surgery has represented the gold standard of care for this
condition, allowing the relief of urinary symptoms and the
consequent improvement in QoL.
Several randomized controlled trials (RCTs) on
phosphodiesterase type 5 inhibitors (PDE-5-Is) have showed
significant improvements in both (LUTS) and (ED) in men
affected by one or both conditions, without a significant
increase in adverse events.
The study was performed to determine the relative
efficacy and safety of PDE5-Is alone or in combination with
alpha-1 adrenergic blockers in LUTS due to BPH. Our study
was conducted on 60 patients diagnosed with LUTS/BPH and
ED presented at Ain shams university hospital.
They were the same age group (50-70 years old) and
were complaining of moderate to severe prostatic symptoms,
with IPSS > 13, when combining sildenafil 25 mg and tamsulosin 0.4 m, or vardenafil 10 mg and tamsulosin 0.4mg,
IPSS score showed greater improvement than using either of
the 2 drugs alone. The same result was found in Q-max and
IIEF.
The combination of PDE5-Is with alpha-blockers induce
statistically significant improvement of maximum flow rate as
compared with alpha-blockers alone, in addition to the positive
effect on micturition and sexual activity.
Younger men with lower BMI and severe urinary
symptoms seem to be the best candidates for PDE5-Is in terms
of improvement of their urinary function. Headache, dyspepsia,
and back pain are the most frequently reported AEs after
PDE5-Is in men with LUTS/BPH.