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BPH/LUTS and ED: Common Pharmacological Pathways for a Common Treatment


Corresponding Author: Ferdinando Fusco, MD PhD, Assistant Professor of Urology, Department of Neuroscience, Reproductive and Odonto-stomatologic Sciences, University Federico II, Naples, Italy. Tel: +39-081-7462611; Fax: +39-0815452959; E-mail:


Introduction and Aim

This article reviews the current literature on common physiopathogenetic factors and pharmacological pathways of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in men and their implications for diagnosis and treatment.

Main Outcome Measures and Methods

A literature search was conducted to identify original articles, reviews, editorials, and international scientific congress abstracts by combining the following terms: lower urinary tract symptoms, erectile dysfunction and phosphodiesterase type 5 inhibitors (and their abbreviations LUTS, ED and PDE5-Is).


We identified manuscripts presenting: (i) The existence of several newly discovered common pathophysiological mechanisms of LUTS and ED indicating that PDE5-Is might represent an alternative to current treatments of men with LUTS (e.g., α1-adrenergic blockers and 5α-reductase inhibitors); (ii) Randomized controlled clinical trials have shown that treatment with PDE5-Is is associated with improvements in both LUTS and ED in men with significant problems in both areas.


The presence of common pathophysiological mechanisms between LUTS and ED seems well recognized and needs further exploration. Further comparisons between different PDE5-Is would be useful to determine the most appropriate regimen and their efficacy to safety ratio. Fusco F, D'Anzeo G, Sessa A, Pace G, Rossi A, Capece M, and d'Emmanuele di Villa Bianca R. BPH/LUTS and ED: Common pharmacological pathways for a common treatment. J Sex Med 2013;10:2382–2393.