Vardenafil Improves Urodynamic Parameters in Men With Spinal Cord Injury: Results From a Single Dose, Pilot Study

Gacci, Mauro; Popolo, Giulio Del; Macchiarella, Angelo; Celso, Maria; Vittori, Gianni; Lapini, A.; Serni, Sergio; Sandner, Peter; Maggi, Mario; Carini, Marco

doi:10.1016/j.juro.2007.07.048

Cited by 82 publications

(51 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PDE5-Is act mainly to relieve the dynamic and static obstruction of the prostate with a direct relaxation of the bladder [8]. Several in vitro studies have reported smooth muscle relaxation in the human bladder neck and prostate in the presence of PDE5-Is [24,25], and relaxation of the bladder neck and decreases in detrusor muscle overactivity have been detected in animal [26] and human studies [27]. Theoretically, the relaxation of the prostate and bladder neck after PDE5-I treatment could increase urinary flow; however, the concomitant relaxation of the detrusor muscle counteracts this effect, thereby preventing the observation of a final improvement in Q max [27].…”

Section: Discussionmentioning

confidence: 99%

“…Several in vitro studies have reported smooth muscle relaxation in the human bladder neck and prostate in the presence of PDE5-Is [24,25], and relaxation of the bladder neck and decreases in detrusor muscle overactivity have been detected in animal [26] and human studies [27]. Theoretically, the relaxation of the prostate and bladder neck after PDE5-I treatment could increase urinary flow; however, the concomitant relaxation of the detrusor muscle counteracts this effect, thereby preventing the observation of a final improvement in Q max [27]. However, in a urodynamic study, tadalafil at a higher dose (20 mg once daily) had no adverse effect on the bladder outlet obstruction index in men with LUTS/BPH [16].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and Safety of Tadalafil Monotherapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Meta-Analysis

et al. 2013

View full text Add to dashboard Cite

Objective: To evaluate the efficacy and safety of tadalafil monotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). Methods: A comprehensive search was done to identify randomized controlled trials comparing the efficacy and safety of tadalafil for LUTS/BPH with placebos. Meta-analytical techniques were applied to evaluate the differences in the study results. Results: Eight studies were identified and analyzed. Compared with placebo, tadalafil was associated with significant improvements in the International Prostate Symptom Score (IPSS) (mean difference = -2.19, p < 0.00001) and the International Index of Erectile Function (IIEF) score (mean difference = +4.66, p < 0.00001), despite the concomitant presence of erectile dysfunction. Significant differences were also observed in the IPSS irritative and obstructive subscores, IPSS quality of life index and BPH impact index. After pooling four doses (2.5, 5, 10 and 20 mg), tadalafil failed to produce a significant outcome in maximal urinary flow rate (Q_max) (mean difference = +0.26 ml/s, p = 0.14), but 5 mg of tadalafil significantly improved Q_max (mean difference = +0.63 ml/s, p = 0.04). No significant difference was detected in the incidence of serious adverse events (risk ratio = 1.00, p = 1.00) after tadalafil treatment. Conclusions: Tadalafil showed good efficacy and safety for improving LUTS and erectile dysfunction in men with BPH, and 5 mg of tadalafil significantly improved Q_max.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Tadalafil Monotherapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Meta-Analysis

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Investigators are testing the efficacy of PDE5-selective inhibitors for reducing symptoms associated with these maladies. Symptoms of overactive bladder syndrome and urge urinary incontinence occur in both male and female patients and are related to those that occur in LUTS; inhibitors that block PDE5 and/or PDE1 activity have shown some promise in relieving symptoms and are considered potential therapies for these problems (Gacci et al, 2007). In addition, use of PDE inhibitors is being tested for treatment of premature ejaculation, Peyronie's disease, and ureteral relaxation for eased passage of kidney stones (Gratzke et al, 2007;Sandner et al, 2009).…”

Section: E Therapeutic Use Of Inhibitors Of Cgmp-hydrolyzing Phosphomentioning

confidence: 99%

cGMP-Dependent Protein Kinases and cGMP Phosphodiesterases in Nitric Oxide and cGMP Action

2010

View full text Add to dashboard Cite

“…This may be explained by the hypothesis that PDE5 inhibitors primarily affect detrusor activity rather than the BOO. 90 A study by Gacci et al 91 in men with neurogenic bladders secondary to spinal cord injury showed that vardenafil treatment resulted in significant improvements in maximum detrussor pressure, total capacity and volume triggered bladder spasms.…”

Section: Luts and Ed: Effects On Clinical Managementmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

View full text Add to dashboard Cite

There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysio logical mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, a1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones. This association has different clinical implications on the management of both disorders. Men seeking care for one condition should always be screened for complaints of the other condition. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment. There may be a potential therapeutic role for testosterone in LUTS treatment in cases of testosterone deficiency that needs to be investigated. Much further investigation is required, but it is evident that the association between LUTS and ED is fundamental for future therapies and possible preventative strategies.

show abstract

Vardenafil Improves Urodynamic Parameters in Men With Spinal Cord Injury: Results From a Single Dose, Pilot Study

Abstract: This trial demonstrates that in spinal cord injured patients a single 20 mg vardenafil administration achieved a significant decrease in maximum detrusor pressure, an improvement in maximum cystometric capacity and a remarkable increase in detrusor overactivity volume value.

Cited by 82 publications

References 17 publications

Efficacy and Safety of Tadalafil Monotherapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Meta-Analysis

Efficacy and Safety of Tadalafil Monotherapy for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Meta-Analysis

cGMP-Dependent Protein Kinases and cGMP Phosphodiesterases in Nitric Oxide and cGMP Action

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Contact Info

Product

Resources

About