How do phosphodiesterase-5 inhibitors help treat BPH?

Marc B. Garnick, MD
Hematology & Oncology
Studies have established a physiological link between erectile dysfunction and the urinary symptoms that accompany benign prostatic hyperplasia (BPH). Prescribed for erectile dysfunction, phosphodiesterase-5 (PDE5) inhibitors augment cyclic guanosine monophosphate (GMP), a chemical that relaxes smooth muscle in the penis, improving blood flow during sexual stimulation. PDE5 inhibitors -- sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) -- also seem to relax smooth muscle in the bladder neck, urethra, and prostate. A handful of clinical trials have shown that these drugs improve both erectile function and urinary symptoms in men with both conditions.

The FDA recently approved tadalafil for both BPH and the erectile dysfunction that frequently accompanies it.

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