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Medikamentöse Therapie des benignen Prostatasyndroms mit Phosphodiesterase-5-Inhibitoren

Medicinal therapy of benign prostate syndrome with phosphodiesterase-5 inhibitors

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Zusammenfassung

Phosphodiesterase-5-Inhibitoren (PDE5-Inhibitoren) wie Sildenafil, Tadalafil und Vardenafil sind Therapie der Wahl bei Männern mit erektiler Dysfunktion (ED). PDE5-Inhibitoren steigern die intrazelluläre Konzentration an cGMP über eine Hemmung der PDE5, woraus eine Relaxation glatter Muskulatur im Schwellkörper entsteht. Dieser Mechanismus wird ebenfalls für die glatte Muskulatur des unteren Harntraktes angenommen. In randomisierten kontrollierten Studien wurde bei Männern mit benignem Prostatasyndrom (BPS) eine Verbesserung von Symptomen des unteren Harntraktes (LUTS) gezeigt. Zusätzlich konnte durch Tadalafil, welches vor kurzem für die Therapie von Patienten mit BPS zugelassen wurde, eine signifikante Verbesserung des maximalen Harnstrahls beobachtet werden.

Abstract

Phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil, tadalafil and vardenafil are first line treatment for erectile dysfunction (ED). These PDE5 inhibitors are known to increase cyclic guanosine monophosphate (cGMP) concentrations in the smooth muscle cells of the corpora cavernosa penis by inhibiting PDE5, leading to smooth muscle relaxation. This mode of action is also believed to result in prostatic smooth muscle relaxation and to improve lower urinary tract symptoms (LUTS). Randomized controlled trials have shown beneficial effects on LUTS and on objective parameters such as maximum urinary flow rate (tadalafil). Based on these data tadalafil was recently approved for treatment of patients with male LUTS; however, the mechanisms leading to improvement of symptoms are still under debate.

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Interessenskonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: CG war und ist tätig für Bayer Healthcare, Sanofi-Aventis, Rottapharm Madaus, Lilly, Recordati und MSD; SM war und ist tätig für Bayer, Madaus, Lilly, MSD, Pfizer, Astellas und GSK.

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Authors and Affiliations

  1. Urologische Klinik und Poliklinik, Klinikum der Universität München-Großhadern, Marchioninistraße 15, 81377, München, Deutschland

    A. Herlemann & C. Gratzke

  2. Klinik für Urologie, Universitätsklinikum Tübingen, Tübingen, Deutschland

    K.D. Sievert

  3. Wake Forest Institute for Regenerative Medicine, North Carolina, NC, USA

    K.-E. Andersson

Authors
  1. A. Herlemann
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  2. C. Gratzke
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  3. K.-E. Andersson
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  4. K.D. Sievert
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Correspondence to A. Herlemann.

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Herlemann, A., Gratzke, C., Andersson, KE. et al. Medikamentöse Therapie des benignen Prostatasyndroms mit Phosphodiesterase-5-Inhibitoren. Urologe 52, 204–211 (2013). https://doi.org/10.1007/s00120-012-3084-2

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  • DOI: https://doi.org/10.1007/s00120-012-3084-2

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