Since the introduction of sildenafil in 1998, phosphodiester-ase-5 (PDE-5) inhibitors have proved to be an effective drug for the treatment of erectile dysfunction (ED). PDE-5 inhibitors are available in >100 countries worldwide. First developed as an antihypertensive drug, the investigators were astonished that the studied subjects reported good erections-a story of success was born. Recently, PDE-5 inhibitors have been shown to be as effective in patients with lower urinary tract symptoms (LUTS) and patients with pulmonary hypertension. In the present review, the authors found 5 randomized controlled trials of 276 citations from medical databases evaluating the effect of PDE-5 inhibitors on LUTS. They found improvements in the International Prostate Symptom Score (IPSS), IPSS irritative and obstructive subscores, IPSS quality of life, and the erectile function domain of the International Index of Erectile Function compared with placebo. However, no statistically significant differences were found for the postvoid residual urine volume or maximal urinary flow rate. From these data, they concluded that PDE-5 inhibitors might be considered as first-line treatment of patients with comorbid BPH and ED in the future.
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