Effectiveness of NO-cGMP axis for lower urinary tract syndrome

Purpose: It is well known NO-cGMP axis plays a critical role in treatment for erectile dysfunction. NO-cGMP axis is expected to not only ED but also LUTS treatment due to regulate the smooth muscle relaxation. Zalutia^Ⓡ is one of the PDE5 inhibitor launched in Japan on 2013 for LUTS treatment. We evaluated the effectiveness of Zalutia^Ⓡ for LUTS and ED treatment.

Material and Methods: Between October 2014 and December 2015, 108 patients were prescribed Zalutia^Ⓡ 5mg per day in Toho University Medical center Omori Hospital. Of 36patients were clinically evaluable such as PSA level, prostate volume, IPSS (International prostate symptom score), flowmetry, EHS (erectile hardness score) and the diary of voiding.

Results: Effective rate for urinary symptoms, especially storage symptoms including nocturia, daytime frequency and urgency, was 53% and for ED was 76%. Medication discontinuance was noted 13 cases. 5 cases were due to no effective, 2 were due to appearance of a new symptom and 6 were due to side effect including hated erecting. Though there was no improvement of the urinary symptom, 5 patients wanted to continue the medication.

Conclusion: PDE5 inhibitor is safe and effective for LUTS treatment. PDE5 inhibitor gives an effect to erectile function supplementary and seems to help not only the urinary symptoms but also the mens health.