Phosphodiesterase Inhibitors in Clinical Urology

PDE: Phosphodiesterase

Authors and Disclosures

Stefan Ückert*^1,2, Markus A Kuczyk¹ and Matthias Oelke<sup>1

1</sup>Department of Urology & Urological Oncology, Division of Surgery, Hannover Medical School, Hannover, Germany
²Institute for Biochemical Research and Analysis, Urological Research Unit, Barsinghausen am Deister, Germany.

Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.

*Author for correspondence
sue_de_99@yahoo.de

Sidebar

Key Issues

• The introduction of inhibitors of the cyclic GMP phosphodiesterase (PDE) 5 into clinical urology is mainly the result of the characterization of the physiology of nonvascular and vascular penile erectile smooth musculature (corpus cavernosum penis).

• The introduction of PDE5 inhibitors as safe and well-tolerated orally active drugs for the treatment of erectile dysfunction has not only become a clinical and pharmaceutical success, but has also brought further attention to PDE isoenzymes as putative pharmacological targets in a variety of disorders of the human genitourinary tract.

• Although the data available present, to a certain degree, clinical, physiological and pharmacological evidence suggesting an efficacy of PDE5 inhibitors in targeting premature ejaculation, there is still much experimental work to be done in order to establish a comprehensive conceptual framework for the future management of premature ejaculation using PDE inhibitors.

• Results from clinical studies on the use of PDE5 inhibitors to treat lower urinary tract symptoms/benign prostatic hyperplasia have been encouraging, however, additional research is needed in order to further elucidate the mechanisms of action of this class of drugs and establish their long-term efficacy in this particular indication. In addition, the clinical effectiveness of combining PDE5 inhibitors and α-adrenoceptor antagonists or antimuscarinic drugs to treat lower urinary tract symptoms/benign prostatic hyperplasia most certainly requires further assessment.

• In patients with overactive bladder dysfunctions, modulating the activity of PDE isoenzymes may represent a novel approach to possibly avoid the limitations of the standard anticholinergic therapy.

• The application of PDE4 inhibitors appears to be a promising option to facilitate with minimal side effects the spontaneous passage of (distal) ureteral stones and relieve pain associated with ureteral colic events.