Asian Journal of Andrology

REVIEW
Year
: 2016  |  Volume : 18  |  Issue : 5  |  Page : 723--731

Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update


Wen-Hao Zhang, Xin-Hua Zhang 
 Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan City 430071, Hubei Province, P.R. China

Correspondence Address:
Xin-Hua Zhang
Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan City 430071, Hubei Province
P.R. China

Phosphodiesterase isoenzymes 5 inhibitors (PDE5-Is) are the first-line therapy for erectile dysfunction (ED). The constant discoveries of nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) cell-signaling pathway for smooth muscle (SM) control in other urogenital tracts (UGTs) make PDE5-Is promising pharmacologic agents against other benign urological diseases. This article reviews the literature and contains some previously unpublished data about characterizations and activities of PDE5 and its inhibitors in treating urological disorders. Scientific discoveries have improved our understanding of cell-signaling pathway in NO/cGMP-mediated SM relaxation in UGTs. Moreover, the clinical applications of PDE5-Is have been widely recognized. On-demand PDE5-Is are efficacious for most cases of ED, while daily-dosing and combination with testosterone are recommended for refractory cases. Soluble guanylate cyclase (sGC) stimulators also have promising role in the management of severe ED conditions. PDE5-Is are also the first rehabilitation strategy for postoperation or postradiotherapy ED for prostate cancer patients. PDE5-Is, especially combined with α-adrenoceptor antagonists, are very effective for benign prostatic hyperplasia (BPH) except on maximum urinary flow rate (Q max ) with tadalafil recently proved for BPH with/without ED. Furthermore, PDE5-Is are currently under various phases of clinical or preclinical researches with promising potential for other urinary and genital illnesses, such as priapism, premature ejaculation, urinary tract calculi, overactive bladder, Peyronie«SQ»s disease, and female sexual dysfunction. Inhibition of PDE5 is expected to be an effective strategy in treating benign urological diseases. However, further clinical studies and basic researches investigating mechanisms of PDE5-Is in disorders of UGTs are required.


How to cite this article:
Zhang WH, Zhang XH. Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update.Asian J Androl 2016;18:723-731


How to cite this URL:
Zhang WH, Zhang XH. Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update. Asian J Androl [serial online] 2016 [cited 2022 Oct 4 ];18:723-731
Available from: https://www.ajandrology.com/article.asp?issn=1008-682X;year=2016;volume=18;issue=5;spage=723;epage=731;aulast=Zhang;type=0