The Efficacy of Mirodenafil for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Middle-Aged Males

Abstract

PurposeThe aim of this study was to investigate the efficacy of mirodenafil in middle-aged male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).Materials and MethodsEighty-eight males with CP/CPPS were randomized to receive either levofloxacin (500 mg/d) (group L, 40 patients) or levofloxacin (500 mg/d) and mirodenafil (50 mg/d) (group ML, 48 patients) for six weeks. The International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire were used to grade symptoms at baseline and 6 weeks after treatment.ResultsThe mean change in total IPSS from baseline was higher in group ML than that in group L (group L, -1.1 vs. group ML, -4.3; p<0.05). Significant improvements were also seen in the IPSS voiding subscore (group L, -0.7 vs. group ML, -3.0; p<0.05). Changes observed in the NIH-CPSI of group ML at six weeks were greater than those at baseline (group L, -3.2 vs. group ML, -7.2; p<0.05). Significant improvements were seen in the NIH-CPSI voiding (group L, -0.5 vs. group ML, -1.7; p<0.05) and quality of life domains (group L, -1.0 vs. group ML, -1.8; p<0.05). Group ML showed a significantly greater increase in the IIEF-EF score than did group ML (group L, +0.2 vs. group ML, +7.8; p<0.05).ConclusionsMirodenafil (50 mg once daily) was well tolerated and resulted in significant symptomatic improvement in middle-aged males with CP/CPPS.

Contemporary Management of Chronic Prostatitis

“…Three studies were identified that highlighted the use of phosphodiesterase inhibitors in the treatment of CP/CPPS (Table 17) [90][91][92]. All three studies looked at phosphodiesterase inhibitors in conjunction with other treatments, which somewhat blurred their true effect.…”

“…These studies were all small, and their follow-ups were no longer than six weeks. Beyond that, only one of these studies directly compared the effect of phosphodiesterase inhibitors with a placebo, and none were double-blinded [90][91][92].…”

UPOINT System: A Diagnostic/Therapeutic Algorithm for Chronic Prostatitis/Chronic Pelvic Pain Syndrome

“…Some studies reported that phosphodiesterase-5 inhibitors could improve the lower urinary tract symptoms (LUTS) by inhibiting nitric oxide synthase. Kong et al [10] reported that the use of mirodenafil in combination with levofloxacin versus levofloxacin alone improved the NIH-CPSI score by -7.2 and -3.2 (p＜0.05), respectively.…”

Recent advances in managing chronic prostatitis/chronic pelvic pain syndrome

“…Studies have shown that phosphodiesterase-5 (PDE-5) inhibitors can improve LUTS by acting upon nitric oxide synthase and PDE-5 present within prostatic tissue. Park and colleagues reported that the use of mirodenafil, a newer PDE-5 inhibitor, in combination with levofloxacin versus levofloxacin alone improved the NIH-CPSI score by –7.2 and –3.2 ( P <0.05), respectively 13 . Significant improvements were also noted in the International Prostatic Symptom Score (IPSS) voiding score and International Index of Erectile Function (IIEF) score.…”