Biology Reference
In-Depth Information
Treatment of Erectile Dysfunction
and Lower Urinary Tract Symptoms
by Phosphodiesterase Inhibitors
Stefan Uckert and Christian G. Stief
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308
2 PDE5 Inhibitors in Male Erectile Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
3 Treating ED by Combining PDE5 Inhibitors with Other Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . 310
4 Upcoming PDE5 Inhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
4.1 Udenafil (DA-8159) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
4.2 Avanafil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
4.3 Lodenafil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
5 PDE Inhibitors in the Treatment of ED: Beyond PDE5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
6 Nonmalignant Diseases of the Prostate: The Benign Prostatic Syndrome . . . . . . . . . . . . . . . . 314
7 Bladder Overactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316
8 Urinary Stone Disease (“Ureteral Colic”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
9 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319
Abstract To date, it is widely accepted that several disorders of the male and
female urogenital tract, such as erectile dysfunction, bladder overactivity, urinary
stone disease, the benign prostatic syndrome, as well as symptoms of female sexual
arousal and orgasmic dysfunctions, can be therapeutically approached by influen-
cing the function of the smooth musculature of the respective organs. To achieve a
pronounced drug effect without significant adverse events, a certain degree of tissue
selectivity is mandatory. Selective intervention in intracellular pathways regulating
S. Uckert ( * )
Division of Surgery, Department of Urology and Urological Oncology, Hannover Medical School,
30625 Hannover, Germany
and
Urological Research Unit, Institute for Biochemical Research and Analysis, Medical Park Business
Area, Hannover, Germany
e-mail: sue_de_99@yahoo.de
C.G. Stief
Faculty of Medicine, Department of Urology, Ludwig-Maximilians-University, University
Hospital Grosshadern, Munich, Germany
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