920: Sildenafil Improves Erectile Function and Concomitant Lower Urinary Tract Symptoms in Men

McVary, Kevin T.; Swierzewski, Mark J.; Monnig, William; Rosenberg, Steven; Bowler, Jessica; Tseng, Li‐Jung; Siegel, Richard L.

doi:10.1016/s0022-5347(18)33156-2

Cited by 5 publications

(4 citation statements)

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“…These results are in line with the effect of PDE-5 inhibitors on isolated organs, where vardenafil and sildenafil are more potent then tadalafil. There are also recent reports from clinical studies in which a reduction of LUTS was reported in patients treated with sildenafil [22,23]. We detected no effects of tadalafil in the present rat model, but a recent report on the use of tadalafil in patients with BPH showed a significantly better IPSS after tadalafil treatment [24].…”

Section: Discussionsupporting

confidence: 59%

Pre‐clinical evidence for the use of phosphodiesterase‐5 inhibitors for treating benign prostatic hyperplasia and lower urinary tract symptoms

et al. 2006

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OBJECTIVE To evaluate the potential of sildenafil, vardenafil and tadalafil, all phosphodiesterase‐5 (PDE‐5) inhibitors used for treating erectile dysfunction, for treating benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). MATERIALS AND METHODS The mRNA expression of the PDE‐5 was determined in rat LUT tissues. The PDE‐5 inhibitors were also tested in organ‐bath experiments and in a partial bladder outlet obstruction (BOO) rat model in vivo. RESULTS The highest PDE‐5 mRNA expression was in the bladder, followed by the urethra and prostate. PDE‐5 inhibitors dose‐dependently reduced the contraction of the isolated bladder, urethral and prostate strips. The rank order of potency was vardenafil > sildenafil > tadalafil. In human prostate stromal cells vardenafil inhibited cell proliferation and was more effective than tadalafil and sildenafil. In the BOO model, there was a reduction in the non‐voiding contractions after bolus intravenous administration of 3 mg/kg sildenafil and vardenafil. CONCLUSION These results show that PDE‐5 is expressed in LUT tissues. PDE‐5 inhibitors induced significant relaxation of these tissues, inhibited the proliferation of human prostate stromal cells and reduced the irritative symptoms of BPH/LUTS in vivo. Therefore, PDE‐5 inhibitors could be used as an effective treatment for BPH/LUTS.

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Section: Discussionsupporting

confidence: 59%

Pre‐clinical evidence for the use of phosphodiesterase‐5 inhibitors for treating benign prostatic hyperplasia and lower urinary tract symptoms

et al. 2006

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“…The study was planned following an earlier trial of sildenafil citrate (Viagra), which is also a PDE5 inhibitor, in which the same placebo control was used and the same endpoint was assessed [24]. The earlier trial recruited 366 men over 45 years old with an IPSS of 12 or more, satisfying various other entry criteria.…”

Section: An Application In the Treatment Of Men With Lower Urinary Trmentioning

confidence: 99%

“…Each option corresponds to a prior mean of = 25, and they imply prior 95 per cent credibility intervals of (0.6, 92.2), (12.0, 42.7) and (20.3, 30.1), respectively. Minimum sample sizes satisfying the 3:1 ratio are (n E , n C , n) = (291, 97, 388), (24,8,32) and (15,5,20), respectively. It can be seen that, as the prior information about the value of becomes more precise, the total necessary sample size falls towards 16, as required when is known.…”

Section: Case 2: Comparing Two Samples Of Normally Distributed Observmentioning

confidence: 99%

Bayesian sample size for exploratory clinical trials incorporating historical data

Whitehead

Valdès-Márquez

Johnson

et al. 2007

Statistics in Medicine

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This paper presents a simple Bayesian approach to sample size determination in clinical trials. It is required that the trial should be large enough to ensure that the data collected will provide convincing evidence either that an experimental treatment is better than a control or that it fails to improve upon control by some clinically relevant difference. The method resembles standard frequentist formulations of the problem, and indeed in certain circumstances involving 'non-informative' prior information it leads to identical answers. In particular, unlike many Bayesian approaches to sample size determination, use is made of an alternative hypothesis that an experimental treatment is better than a control treatment by some specified magnitude. The approach is introduced in the context of testing whether a single stream of binary observations are consistent with a given success rate p(0). Next the case of comparing two independent streams of normally distributed responses is considered, first under the assumption that their common variance is known and then for unknown variance. Finally, the more general situation in which a large sample is to be collected and analysed according to the asymptotic properties of the score statistic is explored.

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“…These two entities may share common physiologic pathways and pathophysiologic mechanisms and may benefit from similar medical treatments. In a recently-presented, placebo-controlled, double-blinded study by McVary et al [61] daily sildenafil was evaluated in men with concomitant erectile dysfunction and LUTS. The authors reported that sildenafil provided significant improvements in erectile function (IIEF score increase þ9.7 versus þ1.86) and significant decrease in LUTS compared with placebo.…”

Section: Drug Combinationsmentioning

confidence: 99%

Management of sildenafil treatment failures

Kendirci

Tanrıverdi

Trost³

et al. 2006

Current Opinion in Urology

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Proper counseling, medication optimization, and modifying associated risk factors can provide success in men who had initially failed sildenafil therapy for erectile dysfunction. Other treatment modalities that may be considered when sildenafil failure occurs include vacuum devices, intraurethral, and intracavernosal administration of vasoactive drugs alone or combined with sildenafil. Penile prosthesis implantation is considered as a last resort, if all first-line and second-line therapies fail.

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920: Sildenafil Improves Erectile Function and Concomitant Lower Urinary Tract Symptoms in Men

Cited by 5 publications

References 0 publications

Pre‐clinical evidence for the use of phosphodiesterase‐5 inhibitors for treating benign prostatic hyperplasia and lower urinary tract symptoms

Pre‐clinical evidence for the use of phosphodiesterase‐5 inhibitors for treating benign prostatic hyperplasia and lower urinary tract symptoms

Bayesian sample size for exploratory clinical trials incorporating historical data

Management of sildenafil treatment failures

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