Volume 6, Number 3Review ArticlesLower Urinary Tract Symptoms, Benign Prostatic Hyperplasia, Erectile Dysfunction, and Phosphodiesterase-5 InhibitorsTreatment UpdateClaus G RoehrbornBenign prostatic hyperplasiaErectile dysfunctionPhosphodiesteraseLower urinary tractsymptoms
Volume 11, Supplement 1Review ArticlesMedical Management of Lower Urinary Tract SymptomsAdvances in the Pharmacologic Treatment of BPHEric E LabordeKevin T McVaryLower urinary tract symptoms (LUTS) are a common complaint among aging men and are often caused by benign prostatic hyperplasia (BPH). A number of medical treatments for LUTS/BPH exist, such as α-blockers, 5α-reductase inhibitors, anticholinergics, phosphodiesterase type 5 (PDE5) inhibitors, and combination therapies. Agonist binding of the α1A-adrenergic receptor (AR), causing prostatic smooth muscle contraction, has been attributed to cause some LUTS. Therefore, medical therapy has aimed to block the α1A-AR and improve LUTS. Determining which therapy to choose must take into account individual patient factors as well as cost and patient choice.[Rev Urol. 2009;11(suppl 1):S19–S25 doi: 10.3909/riu11S1S0004]© 2009 MedReviews®, LLCLower urinary tract symptomsPhosphodiesteraseCombination therapyBlockers5-reductase inhibitorsAnticholinergicsBenign prostatichyperplasia
Volume 16, Number 3Review ArticlesManagement of Erectile Dysfunction in the Hypogonadal Man: A Case-Based ReviewManagement ReviewJason M ScovellRanjith RamasamyNathan A WilkenJason R KovacLarry I LipshultzErectile dysfunction (ED) has emerged as an important marker of cardiovascular and overall health, independent of other known conventional risk factors. ED often precedes coronary artery disease in half of affected subjects, and could indicate the presence of cardiovascular pathology. The pathophysiology and role of androgens in sexual function are described, along with the relevant literature on the effects of aging in erectile and gonadal function. The concept of testosterone supplementation (TST) in men with ED is reviewed. The authors utilize clinical vignettes to discuss the appropriate management of two clinical cases of men at different life stages who have ED in the setting of hypogonadism and propose a treatment algorithm. In patients of all ages, proper identification of the underlying pathophysiology of decreased libido and erectile function is paramount in choosing between the use of TST, phosphodiesterase type 5 inhibitors, or both, in the management of these disorders. [Rev Urol. 2014;16(3):105-109 doi: 10.3909/riu0623] © 2014 MedReviews®, LLCHypogonadismErectile dysfunctionTestosterone supplementationPhosphodiesterase