Phosphodiesterase type-5 (PDE-5) inhibitors are approved as the first line of
therapy for the treatment of
erectile dysfunction. However, different studies have been performed to study the use of these agents in other areas of urology. There are many studies related to the use of
PDE-5 inhibitors as a monotherapy or combination
therapy with alpha-blockers for
lower urinary tract symptoms (LUTS) associated with
benign prostatic hyperplasia (BPH). It has been shown that contractions induced by various agents or electrical field stimulation in organ bath models of prostatic tissue can be reversed by
PDE-5 inhibitors. Age, body mass index and the severity of LUTS are important factors for the selection of patients suitable for this treatment. It has also been reported that the use of
PDE-5 inhibitors can relieve the chronic pelvic
ischemia and endothelial dysfunction associated with
metabolic syndrome. Most of the side effects observed with
PDE-5 inhibitors are minimal and tolerable. The use of
PDE-5 inhibitors is absolutely contraindicated in patients taking
nitrate preparations. A significant interaction has not been observed even when a patient is taking several
antihypertensive agents concurrently. Co-administration of alpha-blockers and
PDE-5 inhibitors may result in
orthostatic hypotension; therefore, patients should be stable on α-blocker
therapy before the initiation of the combination
therapy, and the initial
PDE-5 inhibitor dose should be the lowest possible. In this review, our aim was to evaluate the role of
PDE-5 inhibitors in the treatment of LUTS associated with BPH by analyzing the current literature.