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Testosterone Replacement, Low T, HCG, & Beyond
Prostate Related Issues
Pharmacological treatment of LUTS in BPH:
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<blockquote data-quote="madman" data-source="post: 186730" data-attributes="member: 13851"><p><strong><span style="color: rgb(44, 130, 201)">5. Benefits of PDE5i daily administration on sexual function</span></strong></p><p></p><p>Four types of oral phosphodiesterase 5 (PDE5i) inhibitors have been developed for erectile dysfunction: sildenafil, tadalafil, avanafil, and vardenafil. For all PDE5is, men must take medications on demand prior to sexual activity [72,73]. <strong><em><span style="color: rgb(184, 49, 47)">Contrary to sildenafil, avanafil, and vardenafil, <u>tadalafil is rapidly absorbed after oral administration and has a longer half-life (17.5 h). Steady-state plasma concentrations are reached after 5 days of administration once a day </u>[74,75]. </span></em></strong>Therefore, its daily use has been proposed for the treatment of ED, at the dose of 2.5 and 5 mg, providing a therapeutic option of efficacy and continuous duration compared to the necessary dosage. ED/LUTS secondary to benign prostatic hyperplasia (BPH) can have a profound impact on the quality of life [76] and often occur in older males [77]. <span style="color: rgb(184, 49, 47)"><em><strong><u>It is estimated that 70% of males with LUTS/BPH have simultaneous ED [78]</u>.</strong></em></span><span style="color: rgb(0, 0, 0)"> T</span>he association between ED and LUTS has previously been demonstrated in various large-scale community-based studies [79]. <span style="color: rgb(184, 49, 47)"><strong><em>PDE5i have always been used for the treatment of ED, increasing the signaling of nitric oxide in the genitourinary tract tissues, which causes calcium-dependent vascular smooth muscle relaxation and increased blood flow. <u>Recently it has been suggested that the same mechanism of action may be involved in the amelioration of BPH symptoms [80,81]</u>.</em></strong></span> Currently, daily tadalafil is the only FDA approved PDE5i for the treatment of BPH. Patients suffering from LUTS/BPH and ED can derive maximum benefit from this treatment, although the real limit of this class of drugs is the high cost</p><p></p><p><strong><em><span style="color: rgb(44, 130, 201)">The first-line treatment of medical management of LUTS secondary to BPH is α-1 blocker and 5-ARI. However, especially in young patients, the side effect on sexual function is of concern for both the patient and the doctor, who tends to reduce the use of 5-ARI whenever possible. <u>Therefore, tamsulosin can be useful and safe for the treatment of LUTS secondary to BPH with or without ED</u>.</span></em></strong> <span style="color: rgb(184, 49, 47)"><em><strong>The daily dosage of tadalafil, with the same efficacy, can provide a spontaneous approach to sexual intercourse and better sexual satisfaction [82]. Additionally, daily administration may also have positive psychological and emotional impacts giving the patient more spontaneity, <u>with add-on effects on cytostructural cavernous erectile tissue and metabolic parameters [83]. In fact, Mostafa and colleagues [84] reported on better cavernous architecture with significant morphometric increases in the percentage area of smooth muscles and elastic tissue and a significant decrease in fibrous tissue once tadalafil was chronically administered</u>. </strong></em></span><span style="color: rgb(44, 130, 201)"><em><strong><u>The potential further advantage of using PDE5i in patients with ED and BPH is that with a single pill they have treated both bladder outlet obstruction and LUTS</u>, therefore potentially improve compliance with medical care reducing the number of medications patients need to take. </strong></em></span>Therefore, PDE5-i can be perfect drugs for the treatment of LUTS secondary to benign prostatic hyperplasia associated or not associated with ED and also in young patients.</p></blockquote><p></p>
[QUOTE="madman, post: 186730, member: 13851"] [B][COLOR=rgb(44, 130, 201)]5. Benefits of PDE5i daily administration on sexual function[/COLOR][/B] Four types of oral phosphodiesterase 5 (PDE5i) inhibitors have been developed for erectile dysfunction: sildenafil, tadalafil, avanafil, and vardenafil. For all PDE5is, men must take medications on demand prior to sexual activity [72,73]. [B][I][COLOR=rgb(184, 49, 47)]Contrary to sildenafil, avanafil, and vardenafil, [U]tadalafil is rapidly absorbed after oral administration and has a longer half-life (17.5 h). Steady-state plasma concentrations are reached after 5 days of administration once a day [/U][74,75]. [/COLOR][/I][/B]Therefore, its daily use has been proposed for the treatment of ED, at the dose of 2.5 and 5 mg, providing a therapeutic option of efficacy and continuous duration compared to the necessary dosage. ED/LUTS secondary to benign prostatic hyperplasia (BPH) can have a profound impact on the quality of life [76] and often occur in older males [77]. [COLOR=rgb(184, 49, 47)][I][B][U]It is estimated that 70% of males with LUTS/BPH have simultaneous ED [78][/U].[/B][/I][/COLOR][COLOR=rgb(0, 0, 0)] T[/COLOR]he association between ED and LUTS has previously been demonstrated in various large-scale community-based studies [79]. [COLOR=rgb(184, 49, 47)][B][I]PDE5i have always been used for the treatment of ED, increasing the signaling of nitric oxide in the genitourinary tract tissues, which causes calcium-dependent vascular smooth muscle relaxation and increased blood flow. [U]Recently it has been suggested that the same mechanism of action may be involved in the amelioration of BPH symptoms [80,81][/U].[/I][/B][/COLOR] Currently, daily tadalafil is the only FDA approved PDE5i for the treatment of BPH. Patients suffering from LUTS/BPH and ED can derive maximum benefit from this treatment, although the real limit of this class of drugs is the high cost [B][I][COLOR=rgb(44, 130, 201)]The first-line treatment of medical management of LUTS secondary to BPH is α-1 blocker and 5-ARI. However, especially in young patients, the side effect on sexual function is of concern for both the patient and the doctor, who tends to reduce the use of 5-ARI whenever possible. [U]Therefore, tamsulosin can be useful and safe for the treatment of LUTS secondary to BPH with or without ED[/U].[/COLOR][/I][/B] [COLOR=rgb(184, 49, 47)][I][B]The daily dosage of tadalafil, with the same efficacy, can provide a spontaneous approach to sexual intercourse and better sexual satisfaction [82]. Additionally, daily administration may also have positive psychological and emotional impacts giving the patient more spontaneity, [U]with add-on effects on cytostructural cavernous erectile tissue and metabolic parameters [83]. In fact, Mostafa and colleagues [84] reported on better cavernous architecture with significant morphometric increases in the percentage area of smooth muscles and elastic tissue and a significant decrease in fibrous tissue once tadalafil was chronically administered[/U]. [/B][/I][/COLOR][COLOR=rgb(44, 130, 201)][I][B][U]The potential further advantage of using PDE5i in patients with ED and BPH is that with a single pill they have treated both bladder outlet obstruction and LUTS[/U], therefore potentially improve compliance with medical care reducing the number of medications patients need to take. [/B][/I][/COLOR]Therefore, PDE5-i can be perfect drugs for the treatment of LUTS secondary to benign prostatic hyperplasia associated or not associated with ED and also in young patients. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Prostate Related Issues
Pharmacological treatment of LUTS in BPH:
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