Vol.14: Is the ED curative effective on the enlarged prostate as well?

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【Is the ED curative effective on the enlarged prostate as well?】


ED curatives such as the Viagra, Levitra, Cialis are called PDE5 inhibitors as a generic term. PDE5 (phosphodiesterase-5) is an enzyme which decomposes the substance which is called cyclic GMP (cGMP) in the cells. cGMP is the important substance which gives influence to dilatation of the vessel and neural-transmission and so on, too. Because the cGMP is generated by nitric-monoxide (Nitric oxide: NO), this pathway is called NO/cGMP. The decomposition of cGMP is controlled by inhibiting the PDE5, as a result of increases of cGMP, the penile bloodstream gets better and improves the ED symptom.
The case in which the ED curative which is PDE5 inhibitor is effective on the other diseases besides ED is sometimes reported. This time, we introduce the research which examined effectiveness on the enlarged prostate. The enlarged prostate is a disease which is very much seen among elderly men as it’s similar to ED. It is often noticed in being frequent urination at night and having difficulty starting urination. Because relieving the tension of the smooth muscle of the prostate is effective for improvement of the enlarged prostate, it’s often treated by the medicine which is called α1 blocker at present. The NO/cGMP pathway is effective on the enlarged prostate treatment, too, because it works by making the smooth muscle of the prostate relax. Indeed, some reports in overseas said that using PDE5 inhibitor with the α1 blocker was effective on the enlarged prostate. A paper which was titled “Phosphodiesterase-5 inhibitor and benign prostatic hyperplasia” was posted in a magazine “Current Opinion in Urology” in 2010, and the effectiveness of the ED curative on the enlarged prostate was demonstrated in the research. Specifically Viagra and Cialis were more effective on enlarged prostate improvement by taking with the α1 blocker. Because either ED or enlarged prostate is a type of disease which is often seen among aged men, if it is possible to use the ED curative for enlarged prostate treatment as well, it’ll be a beneficial alternative as it can cure both at the same time. However, because there was a concern about the decrease of blood pressure caused by the intake ED curative based on a prolonged administration and also taking it together with the α1 blocker, the researchers concluded that it was necessary to do a larger-scale and longer-term clinical study in the conclusion of the paper. If the ED curatives are approved as the curative for enlarged prostate, there will be a possibility for the ED curatives to be covered by health insurance, too. Considering this and also the fact that it can cure ED, it’ll be attractive for many people for sure. As for the dosage in these researches, Viagra was 25 mg/day and Cialis was 20 mg/day. If these are taken based on a prolonged-administration, I guess, the dosage would be a lot less than the dosage which is used for ED treatment itself because of the concern about decrease of blood pressure which will be caused by taking them together with the α1 blocker. In this case, I really wonder whether we can expect similar effectiveness to when they are taken only for the ED treatment・・. Whichever it is, this is an area in which we need to see further research results in the future.


【Supervisor of this article】

Ken Takemori, MD. An anesthesiologist and Director of Shibuya 3rd Block Clinic.


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