Volume 7, Number 2Review ArticlesAdjunctive Therapy to Promote Stone PassageDean G AssimosGeoffrey R NussJudson D RackleyShock wave lithotripsyPhosphodiesterase inhibitorsAdrenergic BlockersCalcium channel blockersProgesteroneCOX-2 inhibitors
Volume 9, Number 3Review ArticlesOral and Non-Oral Combination Therapy for Erectile DysfunctionTreatment UpdateAn estimated 30 million men in the United States suffer from varying degrees of erectile dysfunction. Increasing age and comorbidities are likely to increase the number of men who are initially refractory or become refractory to phosphodiesterase (PDE)-5 inhibitors, the most popular oral therapy. Combination therapy, a concept well proved in other areas of medicine, is therefore of increasing importance. Combination oral and non-oral (intracavernosal injection and intraurethral application) therapies have been shown to salvage monotherapy. The early introduction of combination therapy has been shown to expedite both the return of natural function and PDE-5 inhibitor responsiveness in post-prostatectomy patients with no reports of serious adverse events. Larger controlled studies are needed to corroborate those encouraging findings. [Rev Urol. 2007;9(3):99-105]Erectile dysfunctionPhosphodiesterase inhibitorsIntracavernosal injectionIntraurethral applicationAlprostadil
Volume 14, Number 3Review ArticlesUpdate on Phosphodiesterase Type 5 Inhibitors for the Treatment of Lower Urinary Tract Symptoms due to Benign Prostatic HyperplasiaTreatment UpdateSteven A KaplanBilal ChughtaiAlexis E TeDean S EltermanRichard K LeeMany aging men will experience both erectile dysfunction (ED) and benign prostatic hyperplasia (BPH), resulting in lower urinary tract symptoms (LUTS). Basic and clinical evidence suggests common pathogenic mechanisms underlying both LUTS and ED. Decreases in the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway with age result in decreased levels of intracellular cGMP and calcium, leading to diminished smooth muscle relaxation of the bladder and prostate and worsening LUTS. Phosphodiesterase type 5 inhibitors as monotherapy in combination with a-blockers have shown efficacy in treating both LUTS and ED. Tadalafil has recently been approved by the US Food and Drug Administration for the treatment of LUTS secondary to BPH, with or without concomitant ED. [Rev Urol. 2012;14(3/4):79-86 doi: 10.3909/riu0559] © 2013 MedReviews®, LLCBenign prostatic hyperplasiaLower urinary tract symptomsErectile dysfunctionPhosphodiesterase inhibitorsTadalafilSildenafilVardenafil